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PTSD Symptoms and Problematic Smartphone Use in Young Adults Are Indirectly Associated Via Avoidance-Focused Coping
Abstract
Previous studies have demonstrated a link between PTSD and smartphone addiction; however, few studies have examined what may account for this relationship. The current study sought to examine whether problem-focused, emotion-focused, and avoidance-focused coping impacts this relationship among young adults. The study consisted of 538 young adults with potential trauma exposure who completed an online survey assessing PTSD symptoms, coping strategies, and problematic smartphone use. PTSD was associated with problematic smartphone use and all styles of coping, while problematic smartphone use was associated with avoidance coping and emotion-focused coping. Analyses of indirect effects demonstrated that PTSD was indirectly associated with problematic smartphone use via avoidance coping but not problem-focused or emotion-focused coping. Findings indicate that avoidance may play an important role in promoting problematic smartphone use among individuals with trauma-related distress and suggest that approaches aimed at targeting avoidance may be beneficial to both PTSD symptoms and problematic smartphone use.
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Objective
Rates of adolescent mood disorders and adolescent smartphone use have risen in parallel, leading some to suggest that smartphone use might have detrimental effects on adolescents’ moods. Alternatively, it is possible that adolescents turn to smartphone use when experiencing negative mood. The purpose of this study was to explore the relationship between adolescent smartphone use and mood using a longitudinal methodology that measured both in real-time.
Method
This study used an Ecological Momentary Assessment (EMA) procedure completed by 253 12-17-year old participants from across the United States. Participants received short surveys delivered to their smartphones at random points throughout the day. Measures included real-time, in-situ assessments of smartphone use, current mood, and mood before smartphone use.
Results
Based on tests of a multilevel regression model, adolescent moods were positively associated with smartphone use (β = 0.261, F(1,259.49) = 19.120, p < 0.001), and that mood was positively associated with the length of phone use sessions (length of phone use β = 0.100, F(1, 112.88) = 5.616, p = 0.020). Participants also reported significant changes in mood during phone use, such that moods before phone use were significantly lower than moods during phone use (MChange = 0.539, t(2491) = 23.174, p < 0.001). Change in mood (mood before minus mood during phone use) was positively associated with the length of smartphone use sessions (β = 0.097, F(1,122.20) = 4.178, p = 0.043), such that participants who had a higher change in mood were more likely to report a longer length of smartphone use.
Conclusions
Findings suggest that adolescent smartphone use is positively associated with mood. This finding may suggest that adolescents use smartphones for mood modification, which aligns with an understanding of smartphone use as potentially addictive behavior.
Plain Language Summary
Smartphones have arguably become a common necessity in modern society. While it can be used for many practical purposes, its many features increase the risk of overuse, a key element in behavioural addiction. The present study examined withdrawal-related symptoms during a smartphone restriction period, lasting 72 hours. The participants were divided in to two groups where one group was without access to their smartphone, while the other group was allowed to keep their smartphone and use it as they normally would. All participants had to complete a number of questionnaires that were administered three times a day during the restriction period and smartphone addiction scores were assessed on Day 1. The results showed that participants with the highest scores on smartphone addiction in the restricted group were significantly more negatively affected by the restriction (compared to those with lower scores). This appears to indicate that being restricted from using smartphones can cause significant withdrawal symptoms, especially for those at risk of smartphone addiction.
Smartphones are omnipresent in the daily lives of parents and provide access to multiple resources in stressful situations. Thus, smartphones might be valuable coping tools. Previous research has mostly focused on the negative effects of parental phone use. In the present study, we investigated how mothers use smartphones for coping with stress and whether their phone use for coping is effective. We also explored factors on different levels (situation, person, device) which could influence phone use and coping effectiveness. Building on a one-week experience sampling study with over 200 mothers and multilevel models, we found that in stressful situations while being with children, mothers used their smartphones mostly for emotion-focused coping such as self-distraction and taking a break. Problem-focused coping was less prevalent. Mothers reporting increased cognitive phone salience used it more for coping with stress. Phone use for coping compared to no use related to lower stress decrease. No person-, situation-, or device-specific factors moderated the effects of phone use on coping effectiveness. Using positive phone content, however, was associated with increased perceived coping efficacy. Our results suggest that phone use is not generally successful for coping, but that momentary device-specific factors such as content characteristics might determine whether phones can be used for coping in an effective way.
There has been a growing literature that has utilized logged behavior from smartphones to study the impacts of technology use on individuals. One of these proposed impacts has been that people become addicted to their smartphones. Measurements of smartphone addiction do not appear to strongly correlate with actual behavior logged from smartphones. Instead, smartphone addiction may be better explained by distress rather than disordered behavior, but this has not been adequately tested. This study examined the relative contributions of self-reported and actual smartphone behavior alongside key mental health and individual differences in a pre-registered, two-wave study with a two-week re-test. 511 smartphone users (391 at Time 2) completed measures of smartphone usage, attitudes towards smartphone usage, smartphone addiction, other behavioral addictions, mental health, and individual differences. The results suggest smartphone addiction is principally driven by perceived rather than actual usage, especially where these are discordant. Self-reported smartphone usage, other behavioral addictions, and the impulsivity facet of negative urgency are more predictive of smartphone addiction than logged behavior. These results suggest that volume of smartphone usage is insufficient in and of itself to explain problematic smartphone behavior and questions the criterion validity of smartphone addiction measurements.
Posttraumatic stress disorder (PTSD) is a severe mental disorder causing high individual and societal costs. The use of maladaptive emotion regulation (ER) strategies has been identified as a potential contributing factor. This meta-analysis aimed to quantify the associations between PTSD symptoms and rumination, thought suppression and experiential avoidance. The systematic literature search resulted in 5574 studies, 75 of which were included in the analysis. From those eligible studies 189 effect sizes were obtained. For symptoms of posttraumatic stress, large effects were found for associations with rumination (r = .52) and experiential avoidance (r = .48), whereas a medium effect size was found for thought suppression (r = .29). With respect to different PTSD symptom clusters, associations ranged between r = .35 and r = .41 for associations with intrusive re-experiencing, between r = .39 and r = .41 for associations with avoidance, between r = .50 and r = .53 for associations with alterations in cognitions and mood and between r = .41 and r = .45 for associations with alterations in arousal and activity. Few available studies provide some evidence that associations might be somewhat reduced but still substantial in longitudinal compared to cross-sectional studies. These findings provide valuable targets for future investigations with the long-term goal of improving targeted interventions for the prevention and treatment of PTSD symptoms.
Background: The 2022 War in Ukraine has significantly affected the psychological well-being and daily lives of people in many countries.
Objective: Two aims of this transnational study were (1) to compare psychological distress and coping strategies among people living in Ukraine, Poland, and Taiwan, (2) to examine whether the associations between various coping strategies (ie. problem-focused coping, emotion-focused coping, and avoidance) and psychological distress (ie. depression, anxiety, stress, posttraumatic stress disorder symptoms, and hopelessness about the ongoing war) differed among people of various countries during the initial stage of the 2022 War in Ukraine.
Method: In total, 1,598 participants (362 from Ukraine, 1,051 from Poland, and 185 from Taiwan) were recruited using an online advertisement to complete online survey questionnaires, including the Brief Coping Orientation to Problems Experienced inventory; the 21-item Depression, Anxiety and Stress Scale; the Impact of Event Scale-Revised; and a questionnaire devised to assess the level of hopelessness about the ongoing war.
Results: Psychological distress and adoption of coping strategies differed across people of various countries. Among Taiwanese and Polish respondents, avoidant coping strategies were most strongly associated with all categories of psychological distress compared with problem- and emotion-focused coping strategies. However, the associations of various coping strategies with psychological distress differed to a less extent among Ukrainian respondents. In addition, problem- and emotion-focused coping strategies had comparable associations with psychological distress among the people of Ukraine, Poland, and Taiwan.
Conclusions: The 2022 War in Ukraine has affected the psychological well-being of people, especially the Ukrainians. Because of the strong association between the adoption of avoidance coping strategies and psychological distress, despite a less extent among Ukrainian respondents, adaptive coping strategies such as (problem- and emotion-focused) are suggested to help people during times of war.
Although previous studies have shown that perceived stress is positively related to problematic smartphone use, knowledge of mediating and moderating mechanisms underpinning this relationship is quite limited. In this study, we explored whether experiential avoidance mediated the relationship between perceived stress and problematic smartphone use and whether trait mindfulness moderated this mediating process. A total of 763 Chinese college students completed the measures of perceived stress, experiential avoidance, problematic smartphone use, and trait mindfulness. The results indicate that perceived stress was positively related to problematic smartphone use and this relation was partially mediated by experiential avoidance. Furthermore, moderated mediation analysis showed that trait mindfulness moderated the linkage between perceived stress and problematic smartphone use via experiential avoidance. This link became weaker for college students with higher levels of trait mindfulness. The results highlight the value of identifying the underlying mechanisms between perceived stress and college students’ problematic smartphone use.
Objective: Psychopathology, cyberpsychology, and mass media theories link psychological symptoms, such as posttraumatic stress disorder (PTSD), to increased media and technology usage (MTU). Given limited research in this area, we uniquely examined if specific MTU facets were associated with PTSD symptom severity. Method: A sample of 404 socioeconomically diverse adults (Mage = 35.89; 57.4% female) was recruited from Amazon’s Mechanical Turk and completed the Life Events Checklist for DSM–5, Posttraumatic Stress Disorder Checklist for DSM–5, Media and Technology Usage and Attitudes Scale, and Patient Health Questionnaire-9. Results: Hierarchical multiple regression analyses indicated that, controlling for depression severity, greater frequency of TV viewing (p = .004) and media sharing (p = .040) and greater quantity of online friendships (p = .006) were associated with greater PTSD symptom severity. Conclusion: Study findings suggest that the extent of MTU behaviors (especially extent of TV use, media sharing, and online friendships) are important to examine in trauma-exposed individuals with PTSD symptoms. Results generalize to trauma-exposed community members and are considered within the context of current MTU theories.
Introduction
Based on the theoretical frameworks of the Theory of Triadic Influence (TTI), this longitudinal study was designed to examine the mediating role of avoidance/emotion‐focused coping in the relationship between distress tolerance and problematic Internet use (PIU) in a large representative sample of senior high school students in Taiwan.
Methods
Through a 1‐year follow‐up design, 2170 participants were recruited from high schools throughout Taiwan using both stratified and cluster sampling in time 1 (T1), and 1832 students were followed‐up 1 year later (T2).
Results
Structure equation modeling and bootstrap analyses results showed that after controlling for PIU measured at T1, PIU (T2) was significantly predicted by distress tolerance (T1) and fully mediated through avoidance/emotion‐focused coping (T2).
Conclusions
The results not only support the TTI framework, but can also serve as a reference to help educational agencies and mental health organizations create policies and design programs that will help in the prevention of PIU among adolescents. The mediating role of avoidance/emotion‐focused coping in the relationship between distress tolerance and PIU was discussed.
Objective: Consumption of traditional and social media markedly increased at the start of the COVID-19 pandemic as new information about the virus and safety guidelines evolved. Much of the information concerned restrictions on daily living activities and the risk posed by the virus. The term doomscrolling is used to describe the phenomenon of elevated negative affect after viewing pandemic-related media. The magnitude and duration of this effect, however, is unclear. Furthermore, the effect of doomscrolling likely varies based on prior vulnerabilities for psychopathology, such as a history of childhood maltreatment. It was hypothesized that social and traditional media exposure were related to an increase in depression and PTSD and that this increase was moderated by childhood maltreatment severity. Method: Participants completed a baseline assessment for psychopathology and 30 days of daily assessments of depression, PTSD, and pandemic-related media use. Results: Using multilevel modeling, social media exposure was associated with increased depression and PTSD. This association was stronger for those with more severe maltreatment histories. Furthermore, those with more severe baseline psychopathology used more social media during this period. These relations were not observed for traditional media sources. Conclusions: These results suggest that regular viewing of pandemic-related social media is associated with increases in psychopathology for those with existing vulnerabilities. Those with such vulnerabilities should adopt strategies to limit social media consumption.
Background:
Smartphones play a critical role in increasing human-machine interactions, with many advantages. However, the growing popularity of smartphone use has led to smartphone overuse and addiction. This review aims to systematically investigate the impact of smartphone addiction on health outcomes.
Methods:
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to carry out the systematic review. Five electronic databases including Medline, Web of Science, PsycINFO, PubMed, and Scopus were searched to identify eligible studies. Eligible studies were screened against predetermined inclusion criteria and data were extracted according to the review questions. This review is registered in PROSPERO (CRD42020181404). The quality of the articles was assessed using the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.
Results:
A total of 27 of 2550 articles met the inclusion criteria. All of the studies were cross-sectional and focused on physical, mental, and neurological health outcomes. The majority of the studies focused on mental health outcomes and consistent associations were observed between smartphone addiction and several mental health outcomes. Anxiety and depression were commonly found to mediate mental health problems. A wide range of physical health sequelae was also associated with smartphone addiction. Furthermore, there was an association between smartphone addiction and neurological disorders.
Conclusions:
Our findings suggest that there are consistent associations between smartphone addiction and physical and mental health, especially mental health. Social awareness campaigns about smartphone addiction and its impact on physical and mental health are needed. Further studies, especially randomized controlled trials, are warranted to validate the impacts of smartphone addiction.
This article provides a systematic review of existing research on problematic smartphone use (PSU) to guide other researchers in search of relevant studies, and to propose areas for future research. In total, 293 studies were analyzed leading to the development of an overview model in the field of PSU, presenting findings on demographic factors, explanations for smartphone use and why this use becomes problematic, consequences of PSU, and how such use can be corrected. In addition, we considered in which contexts, with which methods, and with which theoretical lenses this stream of research has been studied to date. Smartphone use is most often explained by the smartphone design, and users' emotional health and their ability to control smartphone use. Our review suggests that people who are young, female, and highly educated are more prone to PSU. Emotional health issues are the most frequently identified consequence of PSU. Strategies for correcting PSU fall into three categories: information-enhancing, capacity-enhancing, and behavior reinforcement strategies. The studies on PSU are most often conducted using quantitative surveys with university and college participants considering their personal smartphone use. Whereas a variety of theoretical frameworks have been adopted to investigate PSU, they are often related to identifying factors explaining use and problematic use, and more seldom to analyze the findings. A future research agenda for PSU is proposed consisting of seven key research questions which can be investigated by researchers going forward.
This study explored stress and coping in electronic sports (esports) athletes and the influence of mental toughness (MT), as defined by two prominent conceptualizations: the 4/6Cs and Mental Toughness Index (MTI) frameworks. Participants were 316 esports athletes, ranked in the top 40% of one of five major esports: Defense of the Ancients 2, League of Legends (LoL), Counter Strike: Global Offensive, Overwatch and Rainbow Six: Siege. Participants completed the MTI, Mental Toughness Questionnaire 6 (MTQ6), Stress Appraisal Measure, and Brief COPE inventory. Results showed that MT (via both MT frameworks) was associated with perceived control, and MTQ6 subscales were associated with stress intensity. Mental toughness (both frameworks) was associated with the selection of more problem-focused and emotion-focused coping strategies and less avoidance coping strategies. The results indicate there is some overlap between the MT and stress-coping process in high-performing traditional sports and competitive esports athletes. These results suggest that esports athletes could benefit from sports psychology interventions designed for traditional sports athletes. Finally, the MTQ6 and MTI had low shared variance (20%), suggesting that the two questionnaires appear to measure different aspects of MT.
Objective:
Increases in depression among adolescents have been concurrent with increases in digital media use. In this article, recent trends in mental health among U.S. adolescents and young adults are discussed and theories about their possible connection with concurrent increases in digital media use are presented.
Methods:
Large studies of trends in mental health in the 2000s and 2010s are described and possible mechanisms for the trends are discussed based on existing literature.
Results:
After remaining stable during the early 2000s, the prevalence of mental health issues among U.S. adolescents and young adults began to rise in the early 2010s. These trends included sharp increases in depression, anxiety, loneliness, self-harm, suicidal ideation, suicide attempts, and suicide, with increases more pronounced among girls and young women. There is a growing consensus that these trends may be connected to the rise in technology use. Increased digital media and smartphone use may influence mental health via several mechanisms, including displacement of time spent in in-person social interactions, individually and across the generation, as adolescent cultural norms evolve; disruption of in-person social interactions; interference with sleep time and quality; cyberbullying and toxic online environments; and online contagion and information about self-harm.
Conclusions:
U.S. adolescents and young adults are in the midst of a mental health crisis, particularly among girls and young women. The rise of digital media may have played a role in this problem via several mechanisms.
The present study investigated the influences of coping styles on posttraumatic stress symptoms (PTSS) among a sample of non-clinical college students who were exposed to traumatic events. Ninety-nine college students participated in the study. However, the sample used in the analyses consisted of only 37 participants who fulfilled the DSM-IV criterion A for Posttraumatic Stress Disorder (PTSD) diagnosis. The PTSD Checklist–Civilian Version (PCL-C) and the Brief COPE were used to assess the participants’ PTSS and habitual use of coping strategies, respectively. Bayesian and frequentist correlations showed that emotion-focused coping style was negatively associated with PTSS, while dysfunctional coping style was positively related to PTSS. In the subsequent linear regression on both statistical framework, dysfunctional coping was the only consistent variable predicting more PTSD symptoms. The findings presented here show that lower use of adaptive coping (emotion-focused) and higher use of dysfunctional coping styles on a daily basis are associated to PTSS severity in a non-clinical sample of college students. According to the Bayesian approach, which permits more generalization of data, dysfunctional coping style is determinant to higher levels of PTSS. These findings add new data to the body of research that highlight the critical role of distinct coping strategies in the severity of PTSS.
While smartphones have proven advantageous for individuals and societies, preliminary findings suggest that some individuals may experience distress associated with excessive or problematic smartphone use. The current study presents an emotion dysregulation model of problematic smartphone use where emotion dysregulation theoretically mediates the association between psychological distress (i.e. depression, anxiety, and stress) and problematic smartphone use. Participants were recruited through an online student recruitment system at Memorial University in Newfoundland, Canada. Two hundred and four undergraduate students completed the Depression Anxiety and Stress Scale (DASS-21), the Difficulties in Emotion Regulation Scale (DERS-18), and the Smartphone Addiction Scale-Short Version (SAS-SV). Bivariate correlations revealed significant positive associations between psychological distress, emotion dysregulation, and problematic smartphone use, and a bootstrapped mediation analysis revealed emotion dysregulation as an atemporal mediator in the relation between psychological distress and problematic smartphone use The current model expands upon previous research by using a more holistic conceptualization of emotion dysregulation that includes lack of emotional awareness and clarity, perceived limited access to effective regulation strategies, non-acceptance of emotions, difficulties engaging in goal-directed behaviour, and difficulties with impulse control.
Although research into the effects of stress on university students is plentiful, research on the association between technology and stress is not. The increasing access to smartphones raises concerns about their impact on university students’ abilities to deal with stress. The present study aims to understand stress in university students as well as the impact that smartphones have on coping with stress. Emotion-focused coping, avoidance-focused coping, and problem-focused coping were examined to better understand stress in this sample. A total of 250 university students completed the Perceived Stress Scale (PSS) and Test of Mobile Phone Dependence (TMD). The Brief COPE was used to measure emotion- and problem-focused coping and the Acceptance and Action Questionnaire-2 (AAQ-II) was used to measure avoidance coping. Students who were highly stressed were also more dependent on their smartphones. Smartphone use to cope was also associated with smartphone dependency, and smartphone dependency was highly associated with avoidance and emotion-focused coping. It was also found that students reported being almost as likely to use music and talking with friends and family to cope with stress, as they are to use their smartphone to cope with said stress. This study illustrates that smartphones may be both helpful and harmful to a university student’s ability to combat stress but that it may depend on the student’s coping methods and the extent of their usage. Future research is needed to examine individuals’ smartphone usage in order to understand whether specific applications may have an effect on coping methods and stress levels.
Background
Mental health problems and mental health related mortality have increased among adolescents, particularly girls. These trends have implications for etiology and prevention and suggest new and emerging risk factors in need of attention. The present study estimated age, period, and cohort effects in depressive symptoms among US nationally representative samples of school attending adolescents from 1991 to 2018.Methods
Data are drawn from 1991 to 2018 Monitoring the Future yearly cross-sectional surveys of 8th, 10th, and 12th grade students (N = 1,260,159). Depressive symptoms measured with four questions that had consistent wording and data collection procedures across all 28 years. Age–period–cohort effects estimated using the hierarchical age–period–cohort models.ResultsAmong girls, depressive symptoms decreased from 1991 to 2011, then reversed course, peaking in 2018; these increases reflected primarily period effects, which compared to the mean of all periods showed a gradual increase starting in 2012 and peaked in 2018 (estimate = 1.15, p < 0.01). Cohort effects were minimal, indicating that increases are observed across all age groups. Among boys, trends were similar although the extent of the increase is less marked compared to girls; there was a declining cohort effect among recently born cohorts, suggesting that increases in depressive symptoms among boys are slower for younger boys compared to older boys in recent years. Trends were generally similar by race/ethnicity and parental education, with a positive cohort effect for Hispanic girls born 1999–2004.Conclusions
Depressive symptoms are increasing among teens, especially among girls, consistent with increases in depression and suicide. Population variation in psychiatric disorder symptoms highlight the importance of current environmental determinants of psychiatric disorder risk, and provide evidence of emerging risk factors that may be shaping a new and concerning trend in adolescent mental health.
Excessive smartphone use has been associated with a number of negative consequences for the individual and the environment. Some similarities can be observed between excessive smartphone usage and several behavioural addictions, and continual usage constitutes one of several characteristics included in addiction. In the extreme high end of the distribution of smartphone usage, smartphone restriction might be expected to elicit negative effects for individuals. These negative effects may be regarded as withdrawal symptoms traditionally associated with substance-related addictions. To address this timely issue, the present study examined scores on the Smartphone Withdrawal Scale (SWS), the Fear of Missing Out Scale (FoMOS) and the Positive and Negative Affect Schedule (PANAS) during 72 h of smartphone restriction. A sample of 127 participants (72.4% women), aged 18–48 years (M = 25.0, SD = 4.5), were randomly assigned into one of two conditions: a restricted condition (experimental group, n = 67) or a control condition (control group, n = 60). During the restriction period participants completed the aforementioned scales three times a day. The results revealed significantly higher scores on the SWS and FoMOS for participants allocated to the restricted condition than those assigned to the control condition. Overall the results suggest that smartphone restriction could cause withdrawal symptoms.
The associations of Internet addiction (IA) and smartphone addiction (SA) with mental health problems have been widely studied. We investigated the effects of IA and SA on depression and anxiety while adjusting for sociodemographic variables. In this study, 4854 participants completed a cross-sectional web-based survey including socio-demographic items, the Korean Scale for Internet Addiction, the Smartphone Addiction Proneness Scale, and the subscales of the Symptom Checklist 90 Items-Revised. The participants were classified into IA, SA, and normal use (NU) groups. To reduce sampling bias, we applied the propensity score matching method based on genetics matching. The IA group showed an increased risk of depression (relative risk 1.207; p < 0.001) and anxiety (relative risk 1.264; p < 0.001) compared to NUs. The SA group also showed an increased risk of depression (relative risk 1.337; p < 0.001) and anxiety (relative risk 1.402; p < 0.001) compared to NCs. These findings show that both, IA and SA, exerted significant effects on depression and anxiety. Moreover, our findings showed that SA has a stronger relationship with depression and anxiety, stronger than IA, and emphasized the need for prevention and management policy of the excessive smartphone use.
Post-traumatic stress disorder (PTSD) symptoms are associated with addictive behaviors including problematic smartphone use (PSU). Drawing from existing theoretical models and empirical work, we examined the relation between PTSD symptoms, social/process-oriented smartphone feature uses, and PSU. Specifically, we examined the correlations between social/process-oriented smartphone feature uses with both PTSD symptom clusters (intrusions, avoidance, negative alterations in cognitions and mood, alterations in arousal and reactivity) and PSU and the mediating role of social/process-oriented smartphone feature uses in the relation between PTSD symptom clusters and PSU. The current study used data from a sample of 347 community participants recruited through Amazon’s Mechanical Turk platform. Correlation results indicated that process-oriented smartphone feature uses correlated significantly (positively) with all the PTSD symptom clusters and PSU. Further, mediation results indicated that process-oriented smartphone feature use significantly mediated the relationship between each PTSD symptom cluster and PSU. Beyond highlighting the role of process-oriented smartphone feature uses (e.g., watching videos/TV/movies, reading books/magazines, games) in the relation between PTSD symptoms and PSU, our findings suggest that efforts to reduce PSU among individuals with PTSD symptoms should integrate strategies for reducing process-oriented uses of smartphones.
Common mental health consequences following the experience of potentially traumatic events include Posttraumatic Stress Disorder (PTSD) and addictive behaviors. Problematic smartphone use is a newer manifestation of addictive behaviors. People with anxiety severity (such as PTSD) may be at risk for problematic smartphone use as a means of coping with their symptoms. Unique to our knowledge, we assessed relations between PTSD symptom clusters and problematic smartphone use. Participants (N = 347), recruited through Amazon’s Mechanical Turk (MTurk), completed measures of PTSD and smartphone addiction. Results of the Wald tests of parameter constraints indicated that problematic smartphone use was more related to PTSD’s negative alterations in cognitions and mood (NACM) than to PTSD’s avoidance factor, Wald χ²(1, N = 347) = 12.51, p = 0.0004; and more to PTSD’s arousal compared to PTSD’s avoidance factor, Wald χ²(1, N = 347) = 14.89, p = 0.0001. Results indicate that problematic smartphone use is most associated with negative affect and arousal among trauma-exposed individuals. Implications include the need to clinically assess problematic smartphone use among trauma-exposed individuals presenting with higher NACM and arousal severity; and targeting NACM and arousal symptoms to mitigate the effects of problematic smartphone 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.
Background and aims
This study focuses on the use of popular information and communication technologies (ICTs) by adolescents: the Internet, mobile phones, and video games. The relationship of ICT use and experiential avoidance (EA), a construct that has emerged as underlying and transdiagnostic to a wide variety of psychological problems, including behavioral addictions, is examined. EA refers to a self-regulatory strategy involving efforts to control or escape from negative stimuli such as thoughts, feelings, or sensations that generate strong distress. This strategy, which may be adaptive in the short term, is problematic if it becomes an inflexible pattern. Thus, the aim of this study was to explore whether EA patterns were associated with addictive or problematic use of ICT in adolescents.
Methods
A total of 317 students of the Spanish southeast between 12 and 18 years old were recruited to complete a questionnaire that included questions about general use of each ICTs, an experiential avoidance questionnaire, a brief inventory of the Big Five personality traits, and specific questionnaires on problematic use of the Internet, mobile phones, and video games.
Results
Correlation analysis and linear regression showed that EA largely explained results regarding the addictive use of the Internet, mobile phones, and video games, but not in the same way. As regards gender, boys showed a more problematic use of video games than girls. Concerning personality factors, conscientiousness was related to all addictive behaviors.
Discussion and conclusions
We conclude that EA is an important construct that should be considered in future models that attempt to explain addictive behaviors.
Substance use disorders (SUD) and posttraumatic stress disorder (PTSD) are chronic, debilitating conditions that frequently co-occur. Individuals with co-occurring SUD and PTSD suffer a more complicated course of treatment and less favorable treatment outcomes compared to individuals with either disorder alone. The development of effective psychosocial and pharmacological interventions for co-occurring SUD and PTSD is an active and critically important area of investigation. Several integrated psychosocial treatments for co-occurring SUD and PTSD have demonstrated promising outcomes. While recent studies examining medications to treat co-occurring SUD and PTSD have yielded encouraging findings, there remain substantial gaps in the evidence base regarding the treatment of co-occurring SUD and PTSD. This review will summarize the findings from clinical trials targeting a reduction in SUD and PTSD symptoms simultaneously. These results may improve our knowledge base and subsequently enhance our ability to develop effective interventions for this complex comorbid condition.
Despite its unambiguous advantages, cellular phone use has been associated with harmful or potentially disturbing behaviors. Problematic use of the mobile phone is considered as an inability to regulate one’s use of the mobile phone, which eventually involves negative consequences in daily life (e.g., financial problems). The current article describes what can be considered dysfunctional use of the mobile phone and emphasizes its multifactorial nature. Validated assessment instruments to measure problematic use of the mobile phone are described. The available literature on risk factors for dysfunctional mobile phone use is then reviewed, and a pathways model that integrates the existing literature is proposed. Finally, the assumption is made that dysfunctional use of the mobile phone is part of a spectrum of cyber addictions that encompasses a variety of dysfunctional behaviors and implies involvement in specific online activities (e.g., video games, gambling, social networks, sex-related websites).
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.
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.
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.
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.
The purpose of the present study was to examine the relationship between, multidimensional competitive trait anxiety (cognitive and somatic anxiety), trait cognitive threat appraisal, and coping styles. Five-hundred and fifty male and female athletes of several individual and team sports, between the ages of 15 and 35 (M = 19.8 ± 4.5), completed the translated and adapted versions of the Sport Anxiety Scale and of the Brief COPE, as well as the Cognitive Appraisal Scale in Sport Competition – Threat Perception. Pearson and Canonical correlations showed that higher levels of trait cognitive anxiety and threat appraisal were positively related to emotion-focused and avoidance coping and inversely related to problem-focused coping. Results are discussed in terms of the importance of individual differences in trait anxiety and threat appraisals, regarding athletes' coping styles.
Objective:
To examine whether (a) Living in the Face of Trauma (LIFT), a group intervention to address coping with HIV and childhood sexual abuse (CSA), significantly reduced traumatic stress over a 1-year follow-up period more than an attention-matched support group comparison intervention; and (b) reductions in avoidant coping over time mediated reductions in traumatic stress.
Method:
In a randomized controlled trial, 247 participants completed measures of traumatic stress and avoidant coping at pre- and post intervention, and at 4-, 8-, and 12-month follow-ups. Latent growth curve modeling examined changes over the 5 time points; standardized path coefficients provide estimates of effects.
Results:
As compared with the support intervention, the coping intervention led to a reduction in traumatic stress over time (b = -.20, p < .02). Participants in the coping intervention also reduced their use of avoidant coping strategies more than did participants in the support intervention (b = -.22, p < .05). Mediation analyses showed reductions in avoidant coping related to reductions in traumatic stress (b = 1.45, p < .001), and the direct effect of the intervention on traumatic stress was no longer significant (b = .04, ns), suggesting that changes in avoidant coping completely mediated intervention effects on traumatic stress.
Conclusions:
The LIFT intervention significantly reduced traumatic stress over time, and changes in avoidant coping strategies mediated this effect, suggesting a focus on current stressors and coping skills improvement are important components in addressing traumatic stress for adults living with HIV and CSA.
This article offers a reformulation of the negative reinforcement model of drug addiction and proposes that the escape and avoidance of negative affect is the prepotent motive for addictive drug use. The authors posit that negative affect is the motivational core of the withdrawal syndrome and argue that, through repeated cycles of drug use and withdrawal, addicted organisms learn to detect interoceptive cues of negative affect preconsciously. Thus, the motivational basis of much drug use is opaque and tends not to reflect cognitive control. When either stressors or abstinence causes negative affect to grow and enter consciousness, increasing negative affect biases information processing in ways that promote renewed drug administration. After explicating their model, the authors address previous critiques of negative reinforcement models in light of their reformulation and review predictions generated by their model.
Studies of coping in applied settings often confront the need to minimize time demands on participants. The problem of participant response burden is exacerbated further by the fact that these studies typically are designed to test multiple hypotheses with the same sample, a strategy that entails the use of many time-consuming measures. Such research would benefit from a brief measure of coping assessing several responses known to be relevant to effective and ineffective coping. This article presents such a brief form of a previously published measure called the COPE inventory (Carver, Scheier, & Weintraub, 1989), which has proven to be useful in health-related research. The Brief COPE omits two scales of the full COPE, reduces others to two items per scale, and adds one scale. Psychometric properties of the Brief COPE are reported, derived from a sample of adults participating in a study of the process of recovery after Hurricane Andrew.
Background and objectives
Research has examined reductions in patient distress recounting trauma narratives in Prolonged Exposure (PE) for posttraumatic stress disorder (PTSD). It remains unclear whether changes in distress and avoidance related to environmental trauma reminders matter in PE and other PTSD treatments, including non-exposure Interpersonal Psychotherapy (IPT).
Methods
Data came from adults with chronic PTSD (N = 92) who completed a treatment trial comparing PE, IPT, and Relaxation Therapy (RT). We employed the Self-Initiated In-Vivo Exposure Scale (SIIVES), which measures patient distress from and avoidance of situational trauma reminders, to calculate reliable change in distress and avoidance. PTSD symptoms, depression, quality of life, and functioning assessments were collected before and after 14 weeks of treatment.
Results
Overall, 48.1% of patients experienced reliable change in avoidance, while 51.9% showed reliable change in distress. Rates of reliable change did not differ by treatment group, although PE appeared to achieve reliable change earlier. Only one baseline characteristic predicted reliable change: patients with comorbid depression were less likely to reliably change in avoidance. At post-treatment, patients achieving reliable change had lower PTSD severity and depression and increased quality of life and social functioning. Statistical modeling revealed that changes in distress and avoidance related to subsequent reduction in PTSD symptoms in all three treatment groups, though this relationship appeared strongest in PE.
Limitations
The sample was relatively small.
Conclusions
Change in avoidance and distress associated with situational trauma reminders was associated with a range of clinical outcomes and may represent important factors in multiple PTSD psychotherapies.
Research has demonstrated that posttraumatic stress disorder (PTSD) is associated with internet-related problematic behaviors. However, studies have not explored the linkage between PTSD symptoms and internet gaming disorder (IGD) symptoms. The current study aimed to investigate the relationship between posttraumatic stress symptoms (PTSS) and IGD symptoms via network analysis. We conducted a cross-sectional study with 341 Chinese young adults directly exposed to a typhoon and examined the network structure of PTSS and IGD symptoms, along with bridge symptoms, to elucidate how they co-occur. Results indicated that ‘avoiding external reminders’ and ‘anhedonia’ were identified as the most central symptoms in the PTSD network, whereas ‘preoccupation,’ ‘gaming despite harms’, and ‘loss of control’ ranked highest on centrality in the IGD network. Two bridge symptoms emerged within the combined PTSD and IGD network model: ‘concentration difficulties’ and ‘conflict due to gaming’from among the PTSS and IGD symptoms, respectively. These findings reveal novel associations between PTSS and IGD symptoms and provide an empirically-based hypothesis for how these two disorders may co-occur among individuals exposed to natural disasters.
The Brief COPE is a widely used measure of coping that contains 28 items on 14 factors. Researchers have shortened the inventory, but the factor structure remains debated. A systematic review of peer-reviewed studies published in English between 1997 and 2021 was conducted to determine if a more parsimonious number of factors could be identified. Cumulative Index for Nursing and Allied Health, PsycINFO, PsycARTICLES, Medline, PubMed, and Scopus databases were searched using keywords “Brief COPE” and “factor, valid*, or psychometric.*” Searching yielded 573 articles; cited references added 38; 85 articles met inclusion criteria. Principal components analysis and confirmatory factor analysis were major analytic strategies used (28% and 27%, respectively). Only eight studies analyzed the original 14-factor structure. Factors identified ranged from 2 to 15, with dichotomous factors most frequently identified (25%; n = 21). A smaller number of factors may be able to represent the Brief COPE. Research is needed to test a condensed instrument.
Rationale
It has been recognized that exposure to mass trauma tends to increase the time spent watching television (TV) news. Yet, research on the effects of this tendency on individuals’ well-being yielded inconclusive findings.
Objective
The aim of this longitudinal study is to examine the effects of prior trauma and posttraumatic stress disorder (PTSD) on changes in the amount of TV news watching and its effect on subsequent PTSD. More specifically, we examined the interrelations of prior exposure to war captivity, long-term PTSD trajectories, and amount of change TV news watching with PTSD severity during the COVID-19 pandemic, among aging Israeli combat veterans.
Methods
One-hundred-and-twenty Israeli ex-prisoners of war (ex-POWs) from 1973 Yom Kippur War and 65 matched controls (combat veterans from the same war) were followed up at five points of time: 1991 (T1), 2003 (T2), 2008 (T3), 2015 (T4), and in April–May 2020 (T5), during the outbreak of the COVID-19 pandemic.
Results
Ex-POWs had higher odds of COVID-19 related increase in TV news watching, which, in turn, contributed to PTSD severity at T5. In addition, delayed PTSD trajectory was associated with COVID-19 related increase in TV news watching, which, in turn, contributed to more severe PTSD at T5.
Conclusions
These findings highlight the negative implications of TV news watching during a mass trauma for traumatized individuals. More specifically, they demonstrate its potential pathogenic role in exacerbating prior PTSD among trauma survivors.
A growing body of evidence has demonstrated an association between problematic smartphone use and psychopathological behavior (e.g., internet addiction, depression, anxiety, stress, and sleep quality). However, little is yet known whether problematic and general smartphone use co-occur with depression and whether internet use, stress, anxiety and sleep quality moderate this relationship. The aim of this study was to examine the psychological mechanisms underlying extensive smartphone use and depression using multiple regression and path analysis (PROCESS macro) in a sample of university students. Our findings demonstrated a negative correlation of smartphone use with anxiety, stress, and sleep quality. Extensive smartphone use is related to depression through the mediation of stress; increased smartphone use tends to reduce stress. Moreover, depression leads to higher levels of smartphone use revealing a bi-directional pathway. Taken together, our findings provide solid evidence for a bi-directional hybrid view considering the association between extensive smartphone use and depression mediated by stress. The present study results may help national health authorities to improve the prevention of depression related to modern technology use.
Given the prominent role that smartphones have in everyday life, research in the field has proliferated. From a theoretical perspective, problematic smartphone use (PSPU) is described as a multi-faceted phenomenon entailing a variety of dysfunctional manifestations (e.g., addictive, antisocial and dangerous use). To date, however, there is still a lack of empirical evidence supporting the identification of PSPU as a potential behavioural addiction. Driven by theory, the aim of the present study was to provide an empirically validated model by testing the contribution of specific factors leading to PSPU. Relationships among individual characteristics (internalised psychopathology, impulsivity and personality traits) and PSPU uses (addictive, antisocial and dangerous) were investigated according to the updated version of the theoretical framework provided by the Pathway Model of problematic smartphone use (Billieux et al., 2015). An online survey was administered to a convenience sample (N = 511) of smartphone users in order to examine their daily engagement, problematic usage patterns and related psychological correlates. Path analysis revealed important information about different PSPU components and results are discussed in light of the available literature. Recommendations for future research are proposed to further investigate the problematic behaviour, including the study of additional variables, such as the fear of missing out (FoMO), nomophobia and excessive social media use.
Posttraumatic stress disorder (PTSD) frequently co-occurs with addictive behaviors. Recently, the addictive behavior of excessive smartphone use is being widely researched. Impulsivity commonly relates to PTSD severity and problematic smartphone use. However, unexamined is the mediating role of impulsivity facets (lack of premeditation, negative urgency, sensation seeking, and lack of perseverance) in the PTSD-problematic smartphone use relationship; this was the purpose of the current study. We used data collected from 346 participants recruited through Amazon’s Mechanical Turk (MTurk) platform. PTSD severity, impulsivity facets, and problematic smartphone use were assessed using the PTSD Checklist for DSM-5 (PCL-5), the UPPS Impulsive Behavior Scale, and the Smartphone Addiction Scale-Short Version (SAS-SV), respectively. Negative urgency and lack of perseverance had significant positive correlations with both PTSD severity and problematic smartphone use. Results of mediation analyses indicated that negative urgency significantly mediated the relationship between PTSD severity and problematic smartphone use. Findings support the underlying role of negative urgency in the relation between PTSD severity and problematic smartphone use. Thus, treatments targeting negative urgency may potentially serve to reduce problematic smartphone use among individuals who experience PTSD symptoms.
Objectives:
This study examined national trends in 12-month prevalence of major depressive episodes (MDEs) in adolescents and young adults overall and in different sociodemographic groups, as well as trends in depression treatment between 2005 and 2014.
Methods:
Data were drawn from the National Surveys on Drug Use and Health for 2005 to 2014, which are annual cross-sectional surveys of the US general population. Participants included 172 495 adolescents aged 12 to 17 and 178 755 adults aged 18 to 25. Time trends in 12-month prevalence of MDEs were examined overall and in different subgroups, as were time trends in the use of treatment services.
Results:
The 12-month prevalence of MDEs increased from 8.7% in 2005 to 11.3% in 2014 in adolescents and from 8.8% to 9.6% in young adults (both P < .001). The increase was larger and statistically significant only in the age range of 12 to 20 years. The trends remained significant after adjustment for substance use disorders and sociodemographic factors. Mental health care contacts overall did not change over time; however, the use of specialty mental health providers increased in adolescents and young adults, and the use of prescription medications and inpatient hospitalizations increased in adolescents.
Conclusions:
The prevalence of depression in adolescents and young adults has increased in recent years. In the context of little change in mental health treatments, trends in prevalence translate into a growing number of young people with untreated depression. The findings call for renewed efforts to expand service capacity to best meet the mental health care needs of this age group.
Black mirror or black hole? American phone screen time statistics
- Harmony Healthcare
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The PTSD Checklist for DSM-5 (PCL-5). Scale available from the National Center for PTSD at www
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Checklist for DSM-5 (PCL-5). Scale available from the National Center for PTSD at www. ptsd. va. gov