Fiona Lei Krizel I.

Adiarte
Grade 9- Mendeleev

Reflections on “Depression, Anxiety, and Smartphone Addiction in University Students”

The research study focused on Lebanese university students with mean age of 20
years, while also considering other parallel studies conducted in South Korea, China,
Taiwan, U.S., and Turkey among similar age groups. Smartphone addictive behavior was
prevalent among young people in these countries and some risk factors reported were the
same as in the Lebanese study. No other independent researches were conducted on very
young age groups of elementary and junior high school students who were earlier exposed
to the use of smartphones and getting threatened with addiction to daily use.

The purposes of this study are to assess if smartphone addiction symptoms is

widespread already, in relation to physical, mental and social health, and more importantly,
to explore whether depression or anxiety, independently, contributes to smartphone
addiction level among a sample of Lebanese students, while simultaneously adjusting for
other independent variables, the main reason for this study.

A sample of 688 Notre Dame University students in Lebanon were invited via simple
random sampling method to fill up survey questionnaires, and a 26-item Smartphone
Addiction Inventory (SPAI) Scale, and brief screeners of depression and anxiety (Patient
Health Questionnaire, PHQ-2 and Generalized Anxiety Disorder, GAD-2), which constitute
the two core Diagnostic and Statistical Manual of Mental Disorders items for major
depressive disorder and generalized anxiety disorder. Various questions on socio-
demographics (age, gender, income, residence, hours of work per week),
academics (grades and courses), smartphone use (age at first use of smartphone, duration/
hours of smartphone use during a weekday, purpose for using smartphone), personality
type, and select lifestyle behaviors (smoking, alcohol drinking, frequency of religious
practice). Participants were tasked to answer what type of personality they possess: type A
(aggressive, competitive, angry, cynical, mistrustful), or type B (easygoing, laid-back/ more
relaxed), patient). Also included is a 26-item Smartphone Addiction Inventory (SPAI) Scale
For clear definition of excessive use of smartphone, it should be at least 5 hours spent on a
weekday. Brief screeners of depression and anxiety often used in research (PHQ-2 and
GAD-2) were used, which consist of questions on patient health, anxiety and depression
disorder ( a cut-off score of 3 or greater was recommended for use as a screener for
depression and anxiety in this study. Information on socio-demographic, academic and
lifestyle variables was collected from non-responders and descriptive statistics (standard
deviation measurements, multiple linear regression, Spearman correlation coefficients) were
performed to ensure that responders and non-responders were similar on all these factors.
The method was very much consistent and is similar to methods used in other countries.

The results of the study revealed that the mean age at first use of smartphone was
found to be 15.09±2.12 years, with about 49% reporting excessive smartphone use (more
than 5 hours/weekday). About one- third of the students in the sample were smokers, three-
fifths were alcohol drinkers, one- fifth were depressed, and one- fourth were anxious. The
top three reasons for smartphone use were reported to be texting
(83%), entertainment/calling family members (67%), and calling friends (62%). Other
reasons for using smartphone were for reading news, study-related purposes, depression
and anxiety.

Prevalence of smartphone addiction symptoms (SPAI) were reported. More than

one-fourth of the students in the sample reported indications of compulsive behavior- surfing
the smartphone has negative effects on their physical health, like when crossing the street,
and while driving or waiting for someone while looking at the smartphone, which is
hazardous. They also feel distressed if the stop using the gadget for a while. They fail to
spend less time on the phone, even if they are tired. More than one-fifth of the sample
reported indications of functional impairment- their interaction with family members is
decreased and using smartphone has exercised certain negative effects on their schoolwork
or job performance. They get back pains and eye discomforts. They get less than four hours
of sleep and they feel sleepy at daytime. More than one-sixth of the sample reported
indications of withdrawal- their first thought and impulse upon waking up every morning was
to use the smartphone, they felt uneasy and there was this urge to use it at once after
temporarily stopping to use it. More than two-fifths of the sample reported indications of
tolerance- they were spending more and more time on their smatphone and they were told
more than once that they spent too much time on it.

Much higher smartphone addiction symptoms (SPAI) score was shown among the
junior class (Year 2) than on the senior class (Year 3). Higher SPAI was also reported
among type A personality than on type B personality. Higher SPAI score was also found in
use of smartphone for entertainment and for non-use of it for calling family members and
relatives than for non-users. Also registering higher SPAI score were those with depression
than non-depressed and those with anxiety than non-anxious.

Two mental health problems, depression and anxiety were assessed to predict
addiction level (SPAI score), after controlling for the influence of other variables. Higher
addiction levels (SPAI scores) were found to be significantly associated with higher
depression /anxiety scores, which means that smartphone addiction increases when
depression/anxiety increases. Personality type A, as well as excessive smartphone use
(more than 5 hours per weekday), non-use of smartphone for calling family members and
use of smartphone for entertainment purposes also contributed to higher addiction level
(higher SPAI score). The result means that higher total SPAI score was found to be
significantly associated with higher depression/ anxiety score, personality type A, excessive
smartphone use, non-use of smartphone for calling family members, and use of smartphone
for entertainment purposes, with excessive smartphone use recording the highest score.

The findings in the study among Lebanese students were similar to those done
among students in other countries, like Turkey and South Korea, as regards prevalence
rates of smartphone-related compulsive behavior, functional impairment, tolerance and
withdrawal symptoms. The samples reported decrease in sleep quality (less than 4 hours),
daytime poor performance at work due to smartphone use at night. Other factors like gender,
residence, work hours per week, major field of study, academic performance, lifestyle habits
such as smoking and alcohol drinking, and religious practice did not associate with
smartphone addiction, as revealed in the results of the study. But persons with personality
type A or those who are more competitive, aggressive and impatient (as against type B),
junior students (as against seniors), excessive use of smartphone during a weekday, not
using smartphone to call family members and its use for entertainment (as against reading
news, and study-related purposes), and having depression or anxiety, showed statistically
significant associations with smartphone addiction. The highest contributor for smartphone
addiction turned out to be excessive use of smartphone followed by depression.

I can say that depression and anxiety are risk factors that contribute to smartphone
addiction, although depression is more powerful compared to anxiety. This is true for
university students and young adults but it can also be applied to older people, regardless of
race. If persons are subjected to high stress levels or depressed and lack the capability to
readily solve problems or deal with stress positively, they are more prone to smartphone
addiction. The family and school support is needed to solve this problem.