Jason C. Levine

Problematic smartphone use: A conceptual overview and systematic review of relations with anxiety and depression psychopathology

BACKGROUND Research literature on problematic smartphone use, or smartphone addiction, has proliferated. However, relationships with existing categories of psychopathology are not well defined. We discuss the concept of problematic smartphone use, including possible causal pathways to such use. METHOD We conducted a systematic review of the relationship between problematic use with psychopathology. Using scholarly bibliographic databases, we screened 117 total citations, resulting in 23 peer-reviewer papers examining statistical relations between standardized measures of problematic smartphone use/use severity and the severity of psychopathology. RESULTS Most papers examined problematic use in relation to depression, anxiety, chronic stress and/or low self-esteem. Across this literature, without statistically adjusting for other relevant variables, depression severity was consistently related to problematic smartphone use, demonstrating at least medium effect sizes. Anxiety was also consistently related to problem use, but with small effect sizes. Stress was somewhat consistently related, with small to medium effects. Self-esteem was inconsistently related, with small to medium effects when found. Statistically adjusting for other relevant variables yielded similar but somewhat smaller effects. LIMITATIONS We only included correlational studies in our systematic review, but address the few relevant experimental studies also. CONCLUSIONS We discuss causal explanations for relationships between problem smartphone use and psychopathology.

Fear of missing out, need for touch, anxiety and depression are related to problematic smartphone use

Problematic smartphone use is an important public health challenge and is linked with poor mental health outcomes. However, little is known about the mechanisms that maintain this behavior. We recruited a sample of 308 participants from Amazons Mechanical Turk labor market. Participants responded to standardized measures of problematic smartphone use, and frequency of smartphone use, depression and anxiety and possible mechanisms including behavioral activation, need for touch, fear of missing out (FoMO), and emotion regulation. Problematic smartphone use was most correlated with anxiety, need for touch and FoMO. The frequency of use was most correlated (inversely) with depression. In regression models, problematic smartphone use was associated with FoMO, depression (inversely), anxiety, and need for touch. Frequency of use was associated with need for touch, and (inversely) with depressive symptoms. Behavioral activation mediated associations between smartphone use (both problematic and usage frequency) and depression and anxiety symptoms. Emotional suppression also mediated the association between problematic smartphone use and anxiety. Results demonstrate the importance of social and tactile need fulfillment variables such as FoMO and need for touch as critical mechanisms that can explain problematic smartphone use and its association with depression and anxiety. Problematic smartphone use was most related to the fear of missing out, depression (inversely), and a need for touch.Behavior activation mediated associations between smartphone use and both anxiety and depression.Results demonstrate the importance of social and tactile need fulfillment variables that explain problem smartphone use.

Non-social features of smartphone use are most related to depression, anxiety and problematic smartphone use

Little is known about the mechanisms of smartphone features that are used in sealing relationships between psychopathology and problematic smartphone use. Our purpose was to investigate two specific smartphone usage types process use and social use for associations with depression and anxiety; and in accounting for relationships between anxiety/depression and problematic smartphone use. Social smartphone usage involves social feature engagement (e.g., social networking, messaging), while process usage involves non-social feature engagement (e.g., news consumption, entertainment, relaxation). 308 participants from Amazons Mechanical Turk internet labor market answered questionnaires about their depression and anxiety symptoms, and problematic smartphone use along with process and social smartphone use dimensions. Statistically adjusting for age and sex, we discovered the association between anxiety symptoms was stronger with process versus social smartphone use. Depression symptom severity was negatively associated with greater social smartphone use. Process smartphone use was more strongly associated with problematic smartphone use. Finally, process smartphone use accounted for relationships between anxiety severity and problematic smartphone use. Anxiety was more related to process (or consumption-based) smartphone use than social smartphone use.Depression was inversely associated with problematic smartphone use.Process smartphone use was most associated with problematic smartphone use.Process smartphone use mediated relations between anxiety and problematic smartphone use.Clinical patients with depressive/anxious symptoms should schedule social-related activity, facilitated by smartphones.

Types of smartphone usage and relations with problematic smartphone behaviors: The role of content consumption vs. social smartphone use

Little previous research has clarified which types of smartphone use are related to problematic smartphone behaviors. We sampled 309 community participants online to understand the role of content consumption vs. social smartphone use in relation to specific problematic smartphone behaviors. Bivariate correlations indicated mostly significant relationships between problematic smartphone behaviors and both process and social usage – but with stronger correlations for process usage. Regression analyses, controlling for age and gender, demonstrated that problematic smartphone-related overuse was significantly associated with process smartphone usage, and to a lesser extent - social usage. Positive anticipation problem behaviors were related to process and social usage. Daily life disturbances from a smartphone were inversely related to process and social usage. Results provide insight into the types of problem smartphone behaviors associated with specific uses and gratifications from a smartphone.

Proneness to Boredom Mediates Relationships Between Problematic Smartphone Use With Depression and Anxiety Severity

Research demonstrates that depression and anxiety symptom severity are related to problematic smartphone use (PSU). However, less is known about variables mediating these relationships. This study aimed to test whether proneness to boredom increased PSU. We also tested whether boredom proneness mediates relations between both depression and anxiety symptom severity with PSU. Using a cross-sectional design, we surveyed 298 American college students about their frequency of smartphone use, levels of PSU, depression, anxiety, and boredom proneness. Using structural equation modeling, we modeled depression and anxiety symptom severity predicting boredom proneness, in turn predicting levels of PSU and smartphone use frequency (SUF). Results demonstrate that boredom proneness predicted PSU, but not SUF. Boredom proneness mediated relations between both depression and anxiety symptom severity with PSU levels (but not usage frequency). We discuss the phenomenon in terms of depressed or anxious college students having difficulty attending to their schoolwork, subsequently experiencing boredom, and engaging in PSU to relieve their boredom.

Distress tolerance and mindfulness mediate relations between depression and anxiety sensitivity with problematic smartphone use

Abstract Excessive, problematic smartphone use (PSU) has demonstrated relationships with depression and anxiety severity across studies. However, less is known about psychopathology-related variables that may mediate relations between depression/anxiety with PSU – especially variables involving emotional regulation processes. We recruited 261 college students for a repeated-measures web survey, administered self-report measures of depression, anxiety sensitivity, distress tolerance, mindfulness, smartphone use frequency, and PSU; one month later, participants completed these measures again. We tested a model where depression severity and anxiety sensitivity predicted distress tolerance and mindfulness, in turn predicting smartphone use frequency, and one-month PSU severity, adjusting for age and sex. Distress tolerance and mindfulness were inversely associated with levels of PSU. Distress tolerance mediated relations between anxiety sensitivity and levels of PSU. Mindfulness mediated relations between both depression and anxiety sensitivity with PSU severity. Results are discussed in the context of emotion regulation theory and compensatory internet use theory, with clinical implications for emotion regulation skills training and mindfulness in offsetting PSU.

The association between problematic smartphone use, depression and anxiety symptom severity, and objectively measured smartphone use over one week

Abstract Problematic smartphone use (PSU) is associated with several types of psychopathology, such as depression and anxiety severity. However, the majority of studies reporting these associations have not used objective smartphone use data and/or repeated-measures study design. Our aim was to investigate how self-reported levels of PSU, depression, anxiety, and daily depressive mood relate to objectively measured smartphone use over one week. We assessed objective smartphone use by daily minutes of screen time and number of phone screen unlocks. One hundred and one undergraduate university students participated. Bivariate correlations and latent growth curve analyses showed that PSU severity related to screen time minutes, but not to phone screen unlocking. Depression and anxiety severity were not related to screen time minutes, but negatively correlated with frequency of phone screen unlocking. Additionally, daily depressive mood items did not, in general, predict objective smartphone use for the corresponding day. However, average daily depressive mood over one week positively correlated with PSU levels. These findings and their implications are discussed.

Heart rate variability and generalized anxiety disorder during laboratory-induced worry and aversive imagery

BACKGROUND To date only a few published studies have examined the effect of disorder-relevant stressors on heart rate variability (HRV) in participants meeting a clinical diagnosis of GAD, with conflicting results. The primary aim of this study was to determine if GAD is associated with lower HRV at rest, and whether vagal regulation during task varies by type (i.e., baseline, anticipation, imagery, or worry). METHODS This study investigated resting cardiac vagal tone and vagal regulation in a sample of 40 participants with or without a validated diagnosis of generalized anxiety disorder (GAD). High-frequency heart rate variability (HF-HRV) was used to index cardiac vagal activity. RESULTS GAD was associated with vagal withdrawal during both imagery and worry inductions, but no group differences in resting vagal tone or worry were observed. LIMITATIONS Methodological limitations include inherent limits to generalizability of laboratory-based findings; specifically worry induction and cardiac reactivity to lab-based stressors. CONCLUSIONS The results support the notion that GAD is associated with vagal withdrawal during active bouts of idiographic worry and imagery, and question the assumption that GAD is associated with low resting vagal tone. In light of polyvagal theory these findings provide additional support for the presence of emotion regulation deficits in GAD, and identify specific ANS processes that underlie GAD.

Fear of missing out: Testing relationships with negative affectivity, online social engagement, and problematic smartphone use

Abstract In the present study, we empirically examined the “fear of missing out” (FOMO) construct and its association with psychopathology-related and technology use measures. We carried out an internet-based survey with 296 undergraduate participants and administered self-report questionnaires of FOMO, frequency and type of smartphone use, problematic smartphone use (PSU), and scales of negative affectivity including depression, anxiety, stress, proneness to boredom, and rumination. The results demonstrated that FOMO was related to demographic characteristics (age, sex, race, and relationship status) but with small effect sizes. FOMO was related to all measures of negative affectivity, social use of a smartphone, as well as the severity of PSU. Tests of mediation indicated that each negative affectivity construct mediated the relationship between FOMO and PSU severity, and only rumination mediated relations between FOMO and smartphone use frequency. When reversing the predictor and mediating variables, FOMO mediated relations between negative affectivity and PSU severity. Finally, results demonstrated some support for a single-factor latent construct for FOMO, but male and female participants had a different pattern of factor loadings. Negative affectivity may be a key mechanism by which FOMO may drive PSU, but future research should clarify the directionality among these variables. Gender-related social connectedness differences characterize FOMO.

Anxiety about electronic data hacking: Predictors and relations with digital privacy protection behavior

Purpose Despite concerns about digital privacy, little is known about emotional distress about data hacking and surveillance incidents. The purpose of this paper is to examine variables predicting anxiety about data hacking, and the role that such anxiety and other potentially important variables have in explaining the use of digital privacy protection behavior. Design/methodology/approach In total, 305 participants from an online labor market were sampled who frequently use the internet, surveyed about recent anxiety (using the Generalized Anxiety Disorder-7 scale (GAD-7)), anxiety about data hacking (GAD-7, in reference to data hacking), and issues of digital privacy: news exposure, perceived importance, self-efficacy, protection behavior, and previous hacking victimization. Findings Profession (information technology-related) moderated the symptom structure for recent anxiety, but not data hacking anxiety. Using structural equation modeling, prior hacking victimization predicted anxiety about hacking. Digital privacy protection behavior was related to hacking anxiety and privacy self-efficacy. Data hacking anxiety mediated relations between hacking victimization and privacy protection. Privacy self-efficacy mediated relations between news exposure to hacking incidents and privacy protection. Research limitations/implications Limitations include the self-report nature of the instruments, and use of a selective, non-random sample. Practical implications Results highlight knowledge, self-efficacy, and threat appraisal among IT managers in motivating better digital security practices. Originality/value This is the first study using a standardized instrument of anxiety to examine distress about hacking and predictors of digital privacy protection behavior.