Estimated 1 in 4 children and young people have problematic smartphone usage

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A study by researchers at King’s College London has estimated that one in four children and young people use their smartphones in a way that is consistent with a behavioural addiction. By analysing literature that has been published since 2011 when smartphones first became widespread, the range of studies showed that 10-30% of children and young people used their smartphones in a dysfunctional way, which means an average of 23% were showing problematic smartphone usage (PSU).

PSU was defined as any behaviour linked to smartphones that has the features of an addiction, such as feeling panicky or upset when the phone is unavailable, finding it difficult to control the amount of time spent on the phone and using the phone to the detriment of other enjoyable activities.

The study is the first to investigate the prevalence of PSU in children and young people at this scale, summarising findings from 41 studies that have researched a total of 41,871 teenagers and young people. The 41 studies included 30 from Asia, nine from Europe and two America. 55% of the participants were female, and young women in the 17 to 19-year-old age group were most likely to have PSU.

The researchers also investigated the links of this type of smartphone usage and mental health and found a consistent association between PSU and poor measures of mental health in terms of depressed mood, anxiety, stress, poor sleep quality and educational attainment.

First author Samantha Sohn from the Institute of Psychiatry, Psychology & Neuroscience at King’s College London said: “Behavioural addictions can have serious consequences on mental health and day-to-day functioning, so there is a need for further investigation into problematic smartphone usage in the UK. In order to determine whether PSU should be classified as a behavioural addiction we need longitudinal data looking at PSU in relation to more objective health outcomes, as well as evidence that people with PSU struggle to moderate their use.”

Co-senior author Dr Ben Carter from the Institute of Psychiatry, Psychology & Neuroscience at King’s College London said: “There is currently a lot of public discourse around the possible negative effects of smartphone use, and previous research has tended to only examine the quantity and frequency of time spent on any technology or screen. Our review assesses the effects not just of heavy use, but of dysfunctional smartphone use, and by looking at an ‘addicted’ pattern of behaviour towards smartphones we have established correlations between this type of dysfunctional behaviour and poorer mental health outcomes.” Over the past decade there has been an increase in smartphone use among children and young people and this has occurred at the same time as a rise in common mental disorders in the same age group. To help clarify the possible association between smartphone use and mental health in children and young people the researchers investigated patterns of smartphone-related behaviour, rather than smartphone use per se.

Co-senior author Dr Nicola Kalk from the Institute of Psychiatry, Psychology & Neuroscience at King’s said: “Smartphones are here to stay and there is a need to understand the prevalence of problematic smartphone usage. We don’t know whether it is the smartphone itself that can be addictive or the apps that people use. Nevertheless, there is a need for public awareness around smartphone use in children and young people, and parents should be aware of how much time their children spend on their phones.”

Background: Over the past decade, smartphone use has become widespread amongst today’s children and young people (CYP) which parallels increases in poor mental health in this group. Simultaneously, media concern abounds about the existence of ‘smartphone addiction’ or problematic smartphone use. There has been much recent research concerning the prevalence of problematic smartphone use is in children and young people who use smartphones, and how this syndrome relates to mental health outcomes, but this has not been synthesized and critically evaluated.
Aims: To conduct a systematic review and meta-analysis to examine the prevalence of PSU and quantify the association with mental health harms.
Methods: A search strategy using Medical Subject Headings was developed and adapted for eight databases between January 1, 1st 2011 to October 15th 2017. No language restriction was applied. Of 924 studies identified, 41 were included in this review, three of which were cohort studies and 38 were cross sectional studies. The mental health outcomes were self-reported: depression; anxiety; stress; poor sleep quality; and decreased educational attainment, which were synthesized according to an a priori protocol.

Results: The studies included 41,871 CYP, and 55% were female. The median prevalence of PSU amongst CYP was 23.3% (14.0–31.2%). PSU was associated with an increased odds of depression (OR = 3.17;95%CI 2.30–4.37;I2 = 78%); increased anxiety (OR = 3.05 95%CI 2.64–3.53;I2 = 0%); higher perceived stress (OR = 1.86;95%CI 1.24–2.77;I2 = 65%); and poorer sleep quality (OR = 2.60; 95%CI; 1.39–4.85, I2 = 78%).
Conclusions: PSU was reported in approximately one in every four CYP and accompanied by an increased odds of poorer mental health. PSU is an evolving public health concern that requires greater study to determine the boundary between helpful and harmful technology use. Policy guidance is needed to outline harm reduction strategies.

Samantha Sohn, Phillipa Rees, Bethany Wildridge, Nicola J Kalk, Ben Carter

But Dr Amy Orben, research fellow at the MRC Cognition and Brain Sciences Unit at the University of Cambridge, warned in a BBC News report against assuming there were causal connections between problematic smartphone use and outcomes such as depression.

“It has been shown previously that smartphone effects are not a one-way street, but that mood can impact the amount of smartphone use, as well,” said Orben.

Kings College London

BMC Psychiatry abstract

BBC News report

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