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      Quantifying Smartphone “Use”: Choice of Measurement Impacts Relationships Between “Usage” and Health

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          Abstract

          Problematic smartphone scales and duration estimates of use dominate research that considers the impact of smartphones on people and society. However, issues with conceptualization and subsequent measurement can obscure genuine associations between technology use and health. Here, we consider whether different ways of measuring “smartphone use,” notably through problematic smartphone use (PSU) scales, subjective estimates, or objective logs, lead to contrasting associations between mental and physical health. Across two samples including iPhone ( n = 199) and Android ( n = 46) users, we observed that measuring smartphone interactions with PSU scales produced larger associations between mental health when compared with subjective estimates or objective logs. Notably, the size of the relationship was fourfold in Study 1, and almost three times as large in Study 2, when relying on a PSU scale that measured smartphone “addiction” instead of objective use. Further, in regression models, only smartphone “addiction” scores predicted mental health outcomes, whereas objective logs or estimates were not significant predictors. We conclude that addressing people’s appraisals including worries about their technology usage is likely to have greater mental health benefits than reducing their overall smartphone use. Reducing general smartphone use should therefore not be a priority for public health interventions at this time.

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          A brief measure for assessing generalized anxiety disorder: the GAD-7.

          Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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                Author and article information

                Journal
                Technology, Mind, and Behavior
                American Psychological Association
                2689-0208
                November 30, 2020
                : 1
                : 2
                Affiliations
                [1]Department of Psychology, Lancaster University
                [2]School of Management, University of Bath
                [3]Department of Computer Science, University of Bristol
                [4]School of Psychology, University of Lincoln
                Author notes
                Action Editor: Danielle S. McNamara was the action editor for this article.
                Funding: This work was part funded by the Centre of Research and Evidence on Security Threats (ESRC Award: ES/N009614/1).
                Conflict of interest: None of the authors have any financial, personal, or organizational conflicts of interest.
                Acknowledgements: The authors would like to thank Adam Birkinshaw and Foivos Vantzos for useful comments and suggestions throughout the project. The authors would also like to thank Neil Shaw, Lee Shaw, and Dr. Flora Ioannidou, for helping pilot the smartphone applications. Finally, the authors are grateful to Dr. Jean-François Stich, Dr. Niklas Johannes, and Dr. Linda Kaye for their useful comments and proposed revisions, which greatly improved the article.
                Open Science Disclosures:

                The data are available at https://osf.io/sw38c/

                The experiment materials are available at https://osf.io/a4p78/

                The preregistered design and analysis plan is accessible at https://osf.io/92ebz

                Disclaimer: Interactive content is included in the online version of this article.
                [*] Heather Shaw, Department of Psychology, Lancaster University, Bailrigg, Lancaster, United Kingdom, LA1 4YW h.shaw5@lancaster.ac.uk
                Author information
                https://orcid.org/0000-0003-1449-3160
                https://orcid.org/0000-0001-6172-3323
                https://orcid.org/0000-0001-9886-9043
                https://orcid.org/0000-0002-3519-9262
                https://orcid.org/0000-0001-7447-5445
                Article
                2020-92192-001
                10.1037/tmb0000022
                d05c64ea-0408-4d03-bbc3-bc37540e9de9
                © 2020 The Author(s)

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC-BY-NC-ND). This license permits copying and redistributing the work in any medium or format for noncommercial use provided the original authors and source are credited and a link to the license is included in attribution. No derivative works are permitted under this license.

                History

                Education,Psychology,Vocational technology,Engineering,Clinical Psychology & Psychiatry
                sedentary behaviors,smartphones,digital health,mental health,screen time

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