Authored by Tiffany Field*
Abstract
This narrative review on cell phone (smart phone) addiction in adolescents is based on papers published during the years 2014-2020 that appeared on PubMed and PsycINFO. The prevalence of cell phone addiction has varied widely across countries as have the scales for that addiction. Cell phone addiction effects include psychological problems (loneliness, depression, social anxiety), physical problems (sleep disturbance, hypertension) and problematic behaviors (sexting, substance use). Risk factors/predictors include parental cell phone addiction, Internet addiction, gaming, and fear of missing out. Methodological limitations include the lack of a standard cell phone addiction classification and the reliance on self-report questionnaires that often do not include time spent on cell phones and the nature of cell phone use (texting, scrolling, chatting) as well as potential underlying mechanisms such as social anxiety. Further, most of the studies are cross-sectional, not longitudinal, so that the direction of effects cannot be determined. Researchers, nonetheless, have arbitrarily assigned behaviors as outcome or predictor variables when they may be more validly considered comorbid activities.
Introduction
Cell phone addiction in adolescents: a narrative review
For this narrative review, a literature search was conducted on PubMed and PsycINFO for the years 2014-2020. Exclusion criteria included non-English papers, case studies, under-powered samples and non-juried papers. Following exclusion criteria, 61 papers were included. Although most of the adolescent cell phone addiction papers during these years have focused on negative effects of and risk factors for excessive use by adolescents, this review also includes brief summaries on the prevalence noted in different countries and the different scales that have been developed for assessing cell phone addiction. Only one intervention study was found. This review is accordingly divided into sections on prevalence, effects, risk factors/predictors and an intervention for cell phone addiction.
Prevalence of cell phone addiction
The papers reviewed here, approximately a third used the term smartphone addiction another third referred to it as mobile phone addiction and the most recent papers labeled it cell phone addiction. This variety of terms reflects the diversity of studies across multiple countries, the relative lack of consensus about how to define cell phone addiction and the use of six different scales that have been developed or adapted as abbreviated scales or as culturally relevant measures. The Oxford English dictionary definition of addiction is a “condition of being addicted to a particular substance, thing or activity”. Medically it is a “chronic, relapsing disorder characterized by compulsive seeking, continued use despite harmful consequences and long-lasting changes in the brain”.
Like internet addiction, the prevalence of cell phone addiction has widely varied (2-89%) depending on the scale used and the location of the research (Table 1). And, in some countries, smart phones are continuously connected to the internet (for example, 89% time in a sample of Turkish tenth grade students) (N=609) [1]. Moving from west to east in Europe and then Asian countries, the prevalence rates, the effects and the risk factors have significantly varied. The U.S. is not included in this review of prevalence data inasmuch as no U.S. cell phone addiction prevalence papers appeared in this recent literature. In a study using the Mobile Phone Problem Use Scale, British secondary school students (N=1026) completed questionnaires, and the prevalence of mobile phone addiction was said to be 10% [2].
The problem was greater among adolescents between 11 and 14 years of age and the risk factors were: studied in a public school, considering oneself to be an expert user of technology, and students who attributed the same use to their peers. For Hispanic cultures, the prevalence varied by study. For example, in Barcelona, problematic use of mobile phones was only 2% (and gaming was 6% and Internet problematic use was 14%) [3]. In this sample, problematic mobile phone use was associated with substance use. In a sample of several different Spanish-speaking countries, 50% of the adolescents (N=1276) presented problems with the Internet, mobile phones, video games, instant messaging and social networks [4].
Moving over to Switzerland, in a convenience sample of students from Swiss vocational school classes (N=1519), 17% of the students presented smartphone addiction [5]. In this sample, smartphone addiction was associated with the following risk factors: longer duration of smartphone use on a typical day, a shorter time until first smart phone use occurred during morning hours and reporting that social networking was the most personally relevant smart phone function. Students who engaged in less physical activity and reported greater stress also experienced problematic smart phone use.
Two different groups have studied mobile phone addiction or problematic cell phone use in Italy. One group reported that problematic cell phone use for text messaging increased from 14% in sixth grade to 16% in seventh grade and 20% in eighth grade [6]. A logistic regression suggested that being drunk at least once and excessive energy drink consumption increased the odds of problematic use. Lower odds of problematic use were associated with reading, better academic performance and longer hours of sleep. In a study from Rome, 26% of the Italian students (N=1004) were abusers of mobile phones, while the prevalence of Internet abuse was approximately 15%, and 20% were abusers of both the internet and mobile phones [7].
Three different studies from Turkey appeared in the recent literature on adolescent problematic smartphone use. In one study, problematic smartphone use was detected in 51% of the adolescents (N=150) [8]. In this study, the factors that most predicted problematic smartphone use were somatization, interpersonal sensitivity and hostility. In another Turkish sample 89% of the students (N=609) were connected to the Internet continuously with their smart phones [1]. Male adolescents with high levels of Internet addiction also had high levels of smartphone addiction. In a study that addressed nomophobia (fear of losing one’s cell phone), the data showed that 9% of Turkish adolescents were severely nomophobic, 72% were moderately nomophobic and 20% were mildly nomophobic [9].
In India, the prevalence of mobile phone addiction ranged from 6-49%. The lowest prevalence (6%) was reported in a systematic review [10]. In this review, problematic phone use was associated with feeling insecure, staying up late at night, impaired parentchild relationships, impaired school relationships, compulsive buying, pathological gambling, low mood, tension and anxiety, leisure boredom, hyperactivity, conduct problems and emotional symptoms. This prevalence rate may have been lower than most because of the inclusion of children in the sample.
In a sample of Mumbai adolescents, cell phone dependence was found in as many as 31% of eighth, ninth and 10th grade students (N=415) [11]. In this study, dependence was associated with male gender, type of mobile phone used, average time per day spent on the phone and years of mobile phone usage. An even higher range was reported in a systematic review and meta-analysis on Indian adolescents (39-44% in a sample of 1304) [12]. This meta-analysis suggested that smartphone addiction could lead to dysfunctional interpersonal skills and negative health risks. In a study by the same group of investigators on the phubbing phenomenon (snubbing someone in favor of a mobile phone) in a sample of adolescents from India (N=400), the prevalence was 49% [13]. The predictors of phubbing were Internet addiction, smartphone addiction, fear of missing out and the lack of self-control. The effects of phubbing included depression and distress as well as relationship problems.
South Korea has also been the source of several studies on cell phone use in adolescents. In one study on middle school students (N=370), the prevalence of smartphone addiction was 14% [14]. The addiction group as compared to the non-addiction group had higher scores on “online chat”. They also had higher scores on habitual use, pleasure, communication, games, stress relief, and not being left out. In a regression analysis, the significant risk factors were female gender, preoccupation and conflict. Further, the addiction group had higher scores on parental punishment. This study was unique in elaborating not only the prevalence but the types of use and parental attitudes regarding the adolescents’ smartphone use.
In a larger sample of middle school students in South Korea (N=1261), a greater prevalence was noted for smartphone addiction (31%), likely because an at-risk group was included in the sample [15]. Here, too, they elaborated on the type of use, indicating that mobile messaging was the most prevalent followed by Internet surfing, gaming and social networking. The risk factors for smartphone addiction were daily smart phone use, social networking, duration of use and overuse of gaming.
In an even larger sample of South Korean adolescents (N=1796), the prevalence of at-risk users was 15% for boys and 24% for girls [16]. Those who were at greater risk for smart phone addiction were female, consumed alcohol, had lower academic performance, did not feel refreshed in the morning and initiated sleep after 12 AM.
In still another study from South Korea, middle school students (N=555) were divided into four categories including Internet plus smartphone problem users (50%), problematic Internet users (8%), problematic smartphone users (32%) and healthy users (11%) [17]. The dual-problem users (Internet and smartphone) scored highest on the Addictive Behavior Scale. Problematic Internet use was more prevalent in males and problematic smart phone use was more prevalent in females. In a large sample study (N=10,775) from Taiwan, the focus was specifically on mobile gaming addiction [18]. Problematic mobile gaming was 21% among junior high school students and 19% among senior high school students. The Problematic Mobile Gaming Questionnaire revealed three factors of addiction including compulsion, tolerance and withdrawal.
Gender differences have also been noted on the prevalence of cell phone addiction in adolescents [19]. In a study from Taiwan, adolescent females showed a greater degree of smartphone dependence than adolescent males [20]. This gender difference in prevalence may relate to the negative correlations noted between smartphone dependence and vitality/mental health specifically in males which may have discouraged cell phone dependence in males. In a study from Japan on a sample of high school students (N=195), female adolescents spent more hours a day on smart phones than males [21]. Forty four percent of females and 23% of males spent three hours a day on smart phones. Gender differences also emerged on the type of smartphone use. Females spent longer hours on Internet browsing, on social networking sites and on online chat. Online chat, in turn, was associated with depression. Males spent more time playing games, but their smart phone use was not correlated with depression, a finding that is inconsistent with the inverse relationship between cell phone dependence and mental health just noted in Taiwanese male adolescents.
It is unclear why the prevalence of cell phone addiction has varied so widely (2-89%) across countries and even within countries given that no cross-cultural comparisons have appeared within studies in this literature. The sources of prevalence data have varied on so many other factors that could affect the prevalence rates such as urban versus rural location, survey versus school sampling, younger versus older adolescents, gender distribution of the samples, and type of cell phone addiction scale used.
To read more about this article......Open access Journal of Addiction and Psychology
Please follow the URL to access more information about this article
https://irispublishers.com/oajap/fulltext/cell-Phone-Addiction-in-adolescents.ID.000568.php
To know more about our Journals....Iris Publishers
No comments:
Post a Comment