7 Identifying Problematic Digital Use or Addiction

Research is continuing regarding problem usage and addiction relative to use of technology and digital devices. Griffiths operationally defined technological addiction as one type of behavior addiction that involves human-machine interaction and is non-chemical in nature. The most well-known behavior addiction, gambling disorder, has been categorized to “substance related and addictive disorders” in the current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) because of the similar symptomatology, biological dysfunction, genetic liability, and treatment approach. Another similar behavior pattern, Internet gaming disorder, has also been listed in the research criteria of DSM-5.^[1]

According to the World Health Organization, gaming disorder is defined in the ICD-11 as a pattern of gaming behavior (“digital-gaming” or “video-gaming”) characterized by impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences.^[2]

Compared with computer use, the high accessibility of the smartphone has led to overwhelming smartphone use, thus increasing attention into the investigation of smartphone addiction.

What is Problematic Smartphone Usage Disorder?

Problematic Smartphone Usage (PSU) behaviors involve both process (content consumption of media such as viewing movies and browsing websites) and social (social media interactions such as messaging) aspects of usage (Elhai et al., 2017).^[3]

Excessive smartphone use is associated with psychiatric, cognitive, emotional, medical and brain changes that should be considered by health and education professionals. Excessive use is associated with difficulties in cognitive-emotion regulation, impulsivity, impaired cognitive function, addiction to social networking, shyness and low self-esteem. Medical problems include sleep problems, reduced physical fitness, unhealthy eating habits, pain and migraines, reduced cognitive control and changes in the brain’s gray matter volume.^[4]

Signs & Symptoms of Smartphone Addiction

No specific amount of usage time has been determined to indicate excessive, problematic use, or addiction. Problematic use involves preoccupation with device use, excessive time or resources spent on a device, and use of devices in socially or physically inappropriate situations such as driving.

Problematic phone use has given rise to new terminology, such as: · nomophobia: the fear of not having your phone · textaphrenia: the fear that you can’t send or receive texts

Phantom vibrations: the perception that your phone is ringing or vibrating when it isn’t ^[5]

Signs of smartphone usage disorder include:

• Spending significant time on phone when alone
• Waking up at night to check the phone
• Experiencing anxiety or anger when unable to check the phone
• Neglecting schoolwork, work, or relationships due to distraction with the phone
• Others comment on excessive smartphone usage
• Having difficulty reducing use of phone
• Hiding smartphone usage
• Continuing the behavior despite negative consequences resulting from use

Researchers have proposed diagnostic criteria of six symptom criteria and four functional criteria that could be used to identify smartphone addiction:

Criteria A (Symptom Criteria)

Maladaptive pattern of smartphone use, leading to clinically significant impairment or distress, occurring at any time within the same 3-month period. Three (or more) of the following symptoms having been present:

1. Recurrent failure to resist the impulse to use the smartphone
2. Withdrawal: as manifested by dysphoria, anxiety and/or irritability after a period without smartphone use
3. Smartphone use for a period longer than intended
4. Persistent desire and/or unsuccessful attempts to quit or reduce smartphone use
5. Excessive time spent on using or quitting the smartphone use
6. Continued excessive smartphone use despite knowledge of having a persistent or recurrent physical or psychological problem resulting from smartphone overuse

Criteria B (Functional Criteria)

Functional impairment- two (or more) of the following symptoms have been present

1. Excessive smartphone use resulting in persistent or recurrent physical or psychological problem
2. Smartphone use in a physically hazardous situation (e.g., smartphone use while driving, or crossing the street), or having other negative impacts on daily life
3. Smartphone use resulting in impairment of social relationships, school achievement, or job performance 4. Excessive smartphone use causes significant subjective distress, or is time-consuming

Criteria C

Exclusion criteria- The smartphone addictive behavior is not better accounted for by obsessive–compulsive disorder or by bipolar I disorder.^[6]

Predictors of Digital Overuse and Addiction

The problematic use of cell phones has been associated with personality variables, such as extraversion, neuroticism, self-esteem, impulsivity, self-identity, and self-image. Similarly, sleep disturbance, anxiety, stress, and, to a lesser extent, depression, which are also associated with Internet abuse, have been associated with problematic cell-phone use. Research also reveals the coexistence relationship between problematic cell-phone use and substance use such as tobacco and alcohol.^[7]

Research has shown that excessive use of smartphones was correlated with impairment in the function of the family and relationship with friends, impulsiveness, and low self-esteem in adolescents. Finally, smartphone gaming was associated with excessive smartphone use among adolescents have demonstrated that individuals with an external locus of control had less control over their smartphone use and therefore could have more negative effects such as poor sleep quality, lower academic achievements, and lower ratings of well-being.^[8]