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      Problematic Smartphone Use and Mental Health in Chinese Adults: A Population-Based Study

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          Abstract

          Problematic smartphone use (PSU) has been associated with anxiety and depression, but few explored its mental well-being correlates that could co-occur with or be independent of mental symptoms. We studied the associations of PSU with anxiety, depression, and mental well-being in Hong Kong Chinese adults in a probability-based survey ( N = 4054; 55.0% females; mean age ± SD 48.3 ± 18.3 years). PSU was measured using Smartphone Addiction Scale-Short Version. Anxiety and depression symptoms were evaluated using General Anxiety Disorder screener-2 (GAD-2) and Patient Health Questionnaire-2 (PHQ-2). Mental well-being was measured using Subjective Happiness Scale (SHS) and Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS). Multivariable regression analyzed associations adjusting for sociodemographic and lifestyle-related variables. Associations of PSU with mental well-being were stratified by symptom severity of anxiety (GAD-2 cutoff of 3) and depression (PHQ-2 cutoff of 3). We found that PSU was associated with higher odds of anxiety and depression symptom severity and lower scores of SHS and SWEMWBS. Associations of PSU with lower SHS and SWEMWBS scores remained in respondents who screened negative for anxiety or depression symptoms. To conclude, PSU was associated with anxiety, depression, and impaired mental well-being. Associations of PSU with impaired mental well-being could be independent of anxiety or depression symptoms.

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          Most cited references41

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          Mental Illness and/or Mental Health? Investigating Axioms of the Complete State Model of Health.

          A continuous assessment and a categorical diagnosis of the presence (i.e., flourishing) and the absence (i.e., languishing) of mental health were proposed and applied to the Midlife in the United States study data, a nationally representative sample of adults between the ages of 25 and 74 years (N = 3,032). Confirmatory factor analyses supported the hypothesis that measures of mental health (i.e., emotional, psychological, and social well-being) and mental illness (i.e., major depressive episode, generalized anxiety, panic disorder, and alcohol dependence) constitute separate correlated unipolar dimensions. The categorical diagnosis yielded an estimate of 18.0% flourishing and, when cross-tabulated with the mental disorders, an estimate of 16.6% with complete mental health. Completely mentally healthy adults reported the fewest health limitations of activities of daily living, the fewest missed days of work, the fewest half-day work cutbacks, and the healthiest psychosocial functioning (low helplessness, clear life goals, high resilience, and high intimacy). (c) 2005 APA, all rights reserved.
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            The Smartphone Addiction Scale: Development and Validation of a Short Version for Adolescents

            Objective This study was designed to investigate the revised and short version of the smartphone addiction scale and the proof of its validity in adolescents. In addition, it suggested cutting off the values by gender in order to determine smartphone addiction and elaborate the characteristics of smartphone usage in adolescents. Method A set of questionnaires were provided to a total of 540 selected participants from April to May of 2013. The participants consisted of 343 boys and 197 girls, and their average age was 14.5 years old. The content validity was performed on a selection of shortened items, while an internal-consistency test was conducted for the verification of its reliability. The concurrent validity was confirmed using SAS, SAPS and KS-scale. Receiver operating characteristics analysis was conducted to suggest cut-off. Results The 10 final questions were selected using content validity. The internal consistency and concurrent validity of SAS were verified with a Cronbach's alpha of 0.911. The SAS-SV was significantly correlated with the SAS, SAPS and KS-scale. The SAS-SV scores of gender (p<.001) and self-evaluation of smartphone addiction (p<.001) showed significant difference. The ROC analysis results showed an area under a curve (AUC) value of 0.963(0.888–1.000), a cut-off value of 31, sensitivity value of 0.867 and specificity value of 0.893 in boys while an AUC value of 0.947(0.887–1.000), a cut-off value of 33, sensitivity value of 0.875, and a specificity value of 0.886 in girls. Conclusions The SAS-SV showed good reliability and validity for the assessment of smartphone addiction. The smartphone addiction scale short version, which was developed and validated in this study, could be used efficiently for the evaluation of smartphone addiction in community and research areas.
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              Problematic smartphone use: A conceptual overview and systematic review of relations with anxiety and depression psychopathology.

              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.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                29 January 2020
                February 2020
                : 17
                : 3
                : 844
                Affiliations
                [1 ]School of Nursing, University of Hong Kong, Hong Kong, China; nyguo@ 123456hku.hk (N.G.); luktt@ 123456hku.hk (T.T.L.); leejay@ 123456hku.hk (J.J.L.); nssophia@ 123456hku.hk (S.S.-C.C.)
                [2 ]School of Public Health, University of Hong Kong, Hong Kong, China; syho@ 123456hku.hk (S.Y.H.); hrmrlth@ 123456hku.hk (T.H.L.)
                [3 ]Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK; chen.shen@ 123456imperial.ac.uk
                [4 ]School of Nursing, University of British Columbia, Vancouver, BC V6T 2B5, Canada; John.Oliffe@ 123456ubc.ca
                Author notes
                [* ]Correspondence: mpwang@ 123456hku.hk ; Tel.: +852-3917-6636; Fax: +852-2872-6079
                Author information
                https://orcid.org/0000-0002-1790-3244
                https://orcid.org/0000-0002-7056-1976
                https://orcid.org/0000-0001-9485-0273
                https://orcid.org/0000-0001-9704-2116
                https://orcid.org/0000-0003-4000-2388
                Article
                ijerph-17-00844
                10.3390/ijerph17030844
                7037190
                32013111
                467ce486-62b1-42de-91d8-75b9c50a22ab
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 02 December 2019
                : 24 January 2020
                Categories
                Article

                Public health
                problematic smartphone use,smartphone addiction,anxiety,depression,mental well-being,population-based study

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