Defining Cell Phone Addiction

As a relatively new target of addiction, smartphone use does not easily fit into the standard classifications of impulse disorders provided by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which does separate behavioral addictions from substance addictions. Behavioral excesses related to video games, exercise, food, shopping, work, and the Internet in general (and online sex and gambling in particular) have all shown indications of addictive behavior, but only online gambling has been classified as such by the DSM-5.

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Smartphone Addiction Profile

Overlaps between smartphone overuse and internet addiction (a well-studied phenomenon) are commonly observed, although a recent review by De-Sola Gutierrez, et al 9 suggested prominent features that clearly distinguish the two. The investigators determined that smartphone addiction and internet addictions had different user profiles and motives; smartphone abusers tend to be young and female and seeking social gratification, while internet-addicted individuals are more likely to be male and socially introverted. The review suggested that young women are neurotically drawn to messaging and social networks available on smartphones.

The Gutierrez evaluation pointed to a known vulnerability to many forms of addiction, and most prominently to behavioral addictions, in people with low self-esteem who demonstrate conflict-avoidance tendencies, impulsivity, sensation seeking, low tolerance to physical or psychological pain, and a greater tendency toward depression or dysphoria.21

Diagnostic Criteria for Smartphone Addiction

Recent work by Lin, et al 22 identified 6 behavioral criteria that had the highest diagnostic accuracy for the diagnosis of smartphone addiction:

  1. Continued inability to resist the impulse to use the smartphone
  2. Symptoms of dysphoria, anxiety, or irritability after a period of withdrawal from use
  3. Using the smartphone for a period longer than intended
  4. Persistent desire and/or unsuccessful attempts to quit or reduce smartphone use
  5. Heightened attention to using or quitting smartphone use
  6. Persistent smartphone use despite recurrent physical or psychological consequences

In addition, they identified 4 functional criteria:

  1. Excessive use resulting in persistent or recurrent physical or psychological problems
  2. Use in a physically hazardous situations (such as while driving or crossing the street) or situations that have other negative impacts on daily life
  3. Use that impairs social relationships or performance at school or work
  4. Use that is very time-consuming or causes significant distress

Diagnosis rests upon the presence of 3 or more main criteria plus 2 or more functional criteria, and in which addictive behavior is not associated with obsessive-compulsive disorder or bipolar disorder.

An alternative or adjunctive tool, the Mobile Phone Addiction Craving Scale (MPACS) was developed by De Sola, et al10 in 2017 consisting of 8 Likert-style questions and designed to help a smartphone user self-evaluate the degree of anxiety or restlessness felt by the lack of availability of their smartphone.

Summary

Smartphone addiction is increasingly recognized as a type of behavioral addiction, although it is not yet recognized as such by the DSM-5.The profile of smartphone abuse indicates a pattern that is most prevalent in young females who may have low self-esteem and demonstrate an excessive need for social networking.

Recent research has identified criteria that help establish a diagnosis of smartphone addiction. It is also recommended that clinicians screen for smartphone addiction using the same criteria to identify adolescent patients at risk.

References

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  2. Rosell MC, Sánchez-Carbonell X, Jordana CG, Fargues MB. El adolescente ante las tecnologías de la información y la comunicación: internet, móvil y videojuegos. Papeles del Psicólogo. 2007;28:196-204.
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  8. Verma RK, Rajiah K, Cheang A, Barua A. Textaphrenia: an emerging silent pandemic. Afr J Psychiatry 2014;17:510–511. doi:10.4172/1994-8220.1000e103
  9. De-Sola Gutiérrez J, Rodríguez de Fonseca F, Rubio G. Cell-phone addiction: a review. Front Psychiatry 2016;24;7:175.
  10. 1De-Sola J, Telledo H, Rubio G, de Fonseca FR. Development of a mobile phone addiction craving scale and its validation in a Spanish adult population. Front Psychiatry 2017;8:90.
  11. Hooper V, Zhou Y. Addictive, dependent, compulsive? A study of mobile phone usage. 20th Bled eConference eMergence: Merging and Emerging Technologies, Processes and Institutions; June 3-6, 2007, Bled, Slovenia.
  12. Leung L. Leisure, boredom, sensation seeking, self-esteem, addiction symptoms and patterns of cell phone use. In: Konijn EA, Tanis MA, Utzy S, Linden A, editors. , editors. Mediated Interpersonal Communication. Mahwah, NJ: Lawrence Erlbaum Associates; 2007: pp 359-381.
  13. Jonnes T. Students’ cell phone addiction and their opinions. Elon J Undergrad Res Commun 2014;5:74-80.
  14. Ha JH, Chin B, Park DH, Ryu SH, Yu J. Characteristics of excessive cellular phone use in Korean adolescents. Cyberpsychol Behav. 2008;11:783784. doi:10.1089/cpb.2008.0096
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This article originally appeared on Psychiatry Advisor

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