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      Testing the Bidirectional Associations of Mobile Phone Addiction Behaviors With Mental Distress, Sleep Disturbances, and Sleep Patterns: A One-Year Prospective Study Among Chinese College Students

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          Mobile phone addiction behaviors (MPAB) are extensively associated with several mental and sleep problems. Only a limited number of bidirectional longitudinal papers have focused on this field. This study aimed to examine the bidirectional associations of MPAB with mental distress, sleep disturbances, and sleep patterns.


          A total of 940 and 902 (response rate: 95.9%) students participated at baseline and one-year follow-up, respectively. Self-reported severity of mobile phone addiction was measured using Mobile Phone Involvement Questionnaire (MPIQ). Mental distress was evaluated by using Beck Depression Inventory (BDI) and Zung Self-Rating Anxiety Scale (SAS). Sleep disturbances were assessed by using Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS). Sleep patterns were evaluated by using reduced Morningness-Eveningness Questionnaire (rMEQ), weekday sleep duration, and weekend sleep duration.


          Cross-lagged analyses revealed a higher total score of BDI, SAS, and ISI predicted a greater likelihood of subsequent MPAB, but not vice versa. We found the bidirectional longitudinal relationships between MPAB and the total score of PSQI and ESS. Besides, a higher score of MPIQ at baseline predicts a subsequent lower total score of rMEQ and shorter weekday sleep duration.


          The current study expands our understanding of causal relationships of MPAB with mental distress, sleep disturbances, and sleep patterns.

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          Most cited references 47

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          Electronic media use and sleep in school-aged children and adolescents: A review.

          Electronic media have often been considered to have a negative impact on the sleep of children and adolescents, but there are no comprehensive reviews of research in this area. The present study identified 36 papers that have investigated the relationship between sleep and electronic media in school-aged children and adolescents, including television viewing, use of computers, electronic gaming, and/or the internet, mobile telephones, and music. Many variables have been investigated across these studies, although delayed bedtime and shorter total sleep time have been found to be most consistently related to media use. A model of the mechanisms by which media use may affect sleep is presented and discussed as a vehicle for future research. Copyright 2010 Elsevier B.V. All rights reserved.
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            Integrating psychological and neurobiological considerations regarding the development and maintenance of specific Internet-use disorders: An Interaction of Person-Affect-Cognition-Execution (I-PACE) model.

            Within the last two decades, many studies have addressed the clinical phenomenon of Internet-use disorders, with a particular focus on Internet-gaming disorder. Based on previous theoretical considerations and empirical findings, we suggest an Interaction of Person-Affect-Cognition-Execution (I-PACE) model of specific Internet-use disorders. The I-PACE model is a theoretical framework for the processes underlying the development and maintenance of an addictive use of certain Internet applications or sites promoting gaming, gambling, pornography viewing, shopping, or communication. The model is composed as a process model. Specific Internet-use disorders are considered to be the consequence of interactions between predisposing factors, such as neurobiological and psychological constitutions, moderators, such as coping styles and Internet-related cognitive biases, and mediators, such as affective and cognitive responses to situational triggers in combination with reduced executive functioning. Conditioning processes may strengthen these associations within an addiction process. Although the hypotheses regarding the mechanisms underlying the development and maintenance of specific Internet-use disorders, summarized in the I-PACE model, must be further tested empirically, implications for treatment interventions are suggested.
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              Relationship of Smartphone Use Severity with Sleep Quality, Depression, and Anxiety in University Students

              Background and Aims The usage of smartphones has increased rapidly in recent years, and this has brought about addiction. The aim of the current study was to investigate the relationship between smartphone use severity and sleep quality, depression, and anxiety in university students. Methods In total, 319 university students (203 females and 116 males; mean age = 20.5 ± 2.45) were included in the study. Participants were divided into the following three groups: a smartphone non-user group (n = 71, 22.3%), a low smartphone use group (n = 121, 37.9%), and a high smartphone use group (n = 127, 39.8%). All participants were evaluated using the Pittsburgh Sleep Quality Index, Beck Depression Inventory, Beck Anxiety Inventory; moreover, participants other than those in the smartphone non-user group were also assessed with the Smartphone Addiction Scale. Results The findings revealed that the Smartphone Addiction Scale scores of females were significantly higher than those of males. Depression, anxiety, and daytime dysfunction scores were higher in the high smartphone use group than in the low smartphone use group. Positive correlations were found between the Smartphone Addiction Scale scores and depression levels, anxiety levels, and some sleep quality scores. Conclusion The results indicate that depression, anxiety, and sleep quality may be associated with smartphone overuse. Such overuse may lead to depression and/or anxiety, which can in turn result in sleep problems. University students with high depression and anxiety scores should be carefully monitored for smartphone addiction.

                Author and article information

                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                17 July 2020
                : 11
                1 Department of Psychiatry, Nanfang Hospital, Southern Medical University , Guangzhou, China
                2 Guangdong-Hong Kong-Macao Greater Bay Area Center for Brian Science and Brain-Inspired Intelligence , Guangzhou, China
                3 Department of Internal Medicine, Zhaoqing Medical College , Zhaoqing, China
                4 Department of Psychiatry, Faculty of Medicine, Chinese University of Hong Kong , Hong Kong, Hong Kong
                Author notes

                Edited by: Marc N. Potenza, Yale University, United States

                Reviewed by: Amir H. Pakpour, Qazvin University of Medical Sciences, Iran; Chung-Ying Lin, Hong Kong Polytechnic University, Hong Kong

                *Correspondence: Bin Zhang, zhang73bin@ 123456hotmail.com

                This article was submitted to Addictive Disorders, a section of the journal Frontiers in Psychiatry

                Copyright © 2020 Kang, Liu, Yang, Xu, Lin, Xie, Zhang, Zhang and Zhang

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                Page count
                Figures: 3, Tables: 2, Equations: 0, References: 56, Pages: 9, Words: 4705
                Funded by: Southern Medical University 10.13039/501100010096
                Funded by: Guangzhou Municipal Science and Technology Project 10.13039/501100010256
                Funded by: National Natural Science Foundation of China 10.13039/501100001809
                Original Research


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