Smartphone addiction is associated with symptoms of anxiety, depression, stress, tension, confusion, and insomnia: A cross-sectional and comparative study with physically and non-physically active adults in self-isolation during the COVID-19 pandemic

Luiz José Frota Solon Júnior, Carlos Henrique Tomaz Ribeiro, Leonardo de Sousa Fortes, Bruno Teixeira Barbosa, Luiz Vieira da Silva Neto

DOI: https://doi.org/10.17711/SM.0185-3325.2021.025

Abstract


Introduction. During the novel coronavirus disease (COVID-19) outbreak, social media exposure and the use of electronic devices have increased; still, these behaviors may cause adverse health effects.

Objective. This study assessed sleep quality, insomnia, mood, and psychological aspects among physically (n = 46) and non-physically (n = 53) active individuals during self-isolation throughout the COVID-19 pandemic and examined their association with smartphone addiction.

Method. A cross-sectional study was conducted among adult Brazilian citizens in self-isolation for at least 60 days; ninety-nine volunteers from different Brazilian regions were enrolled in the online survey. The Depression, Anxiety and Stress Scale-Short Form, the Pittsburgh Sleep Quality Index, the Insomnia Severity Index, the Brunel Mood Scale, and the Smartphone Addiction Scale-Short Version were used to assess the study outcomes.

Results. The results indicate moderate and large correlations of smartphone addiction with mood subscales, insomnia (r = .52), anxiety (r = .49), depression (r = .49), and stress (r = .49) symptoms. Also, it was observed that physically active participants were less addicted to smartphones than the non-physically active during self-isolation (pp = .02), depression (pp
Discussion and conclusion. These findings show the health implications of self-isolation and how essential it is to be physically active to avoid self-isolationʼs adverse psychological effects.

Keywords


Coronavirus; self-isolation; physical activity; addiction; psychological aspects

Full Text:

HTML PDF EPUB

References


Bao, Y., Sun, Y., Meng, S., Shi, J., & Lu, L. (2020). 2019-nCoV epidemic: address mental health care to empower society. The Lancet, 395(10224), e37-e38. doi: 10.1016/S0140-6736(20)30309-3

Bastien, C. H., Vallières, A., & Morin, C. M. (2001). Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Medicine, 2(4), 297-307. doi: 10.1016/S1389-9457(00)00065-4

Brietzke, E., Magee, T., Freire, R. C. R., Gomes, F. A., & Milev, R. (2020). Three insights on psychoneuroimmunology of mood disorders to be taken from the COVID-19 pandemic. Brain, Behavior, & Immunity - Health, 5, 100076. doi: 10.1016/j.bbih.2020.100076

Bull, F. C., Al-Ansari, S. S., Biddle, S., Borodulin, K., Buman, M. P., Cardon, G… Willumsen, J. F. (2020). World Health Organization 2020 guidelines on physical activity and sedentary behaviour. British Journal of Sports Medicine, 54(24), 1451-1462. doi: 10.1136/bjsports-2020-102955

Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193-213. doi: 10.1016/0165-1781(89)90047-4

Chen, P., Mao, L., Nassis, G. P., Harmer, P., Ainsworth, B. E., & Li, F. (2020). Coronavirus disease (COVID-19): The need to maintain regular physical activity while taking precautions. Journal of Sport and Health Science, 9(2), 103-104. doi: 10.1016/j.jshs.2020.02.001

Chennaoui, M., Arnal, P. J., Sauvet, F., & Léger, D. (2015). Sleep and exercise: A reciprocal issue? Sleep Medicine Reviews, 20, 59-72. doi: 10.1016/j.smrv.2014.06.008

Chung, J. E., Choi, S. A., Kim, K. T., Yee, J., Kim, J. H., Seong, J. W., … Gwak, H. S. (2018). Smartphone addiction risk and daytime sleepiness in Korean adolescents. Journal of Paediatrics and Child Health, 54(7), 800-806. doi: 10.1111/jpc.13901

Cohen, J. (1988). Statistical power analysis for the behavioral sciences, 2nd ed. (pp. 1-490). Retrieved from https://books.google.es/books?id=rEe0BQAAQBAJ&dq=Statistical+power+analysis+for+the+behavioral+sciences+(2nd+ed.)&lr=&hl=es&source=gbs_navlinks_s

de Araujo, P. A. B., Sties, S. W., Wittkopf, P. G., Netto, A. S., Gonzáles, A. I., Lima, D. P., ...de Carvalho, T. (2015). Índice Da Qualidade Do Sono De Pittsburgh Para Uso Na Reabilitação Cardiopulmonar E Metabólica. Revista Brasileira de Medicina Do Esporte, 21(6), 472-475. doi: 10.1590/1517-869220152106147561

DʼAurea, C. V. R., Poyares, D., Passos, G. S., Santana, M. G., Youngstedt, S. D., Souza, A. A., … de Mello, M. T. (2019). Effects of resistance exercise training and stretching on chronic insomnia. Revista Brasileirade Psiquiatria, 41(1), 51-57. doi: 10.1590/1516-4446-2018-0030

Eide, T. A., Aarestad, S. H., Andreassen, C. S., Bilder, R. M., & Pallesen, S. (2018). Smartphone restriction and its effect on subjective withdrawal related scores. Frontiers in Psychology, 9(1444), 1-11. doi: 10.3389/fpsyg.2018.01444

Elhai, J. D., Levine, J. C., & Hall, B. J. (2019). The relationship between anxiety symptom severity and problematic smartphone use: A review of the literature and conceptual frameworks. Journal of Anxiety Disorders, 62, 45-52. doi: 10.1016/j.janxdis.2018.11.005

Elhai, J. D., Yang, H., Fang, J., Bai, X., & Hall, B. J. (2020). Depression and anxiety symptoms are related to problematic smartphone use severity in Chinese young adults: Fear of missing out as a mediator. Addictive Behaviors, 101, 105962. doi: 10.1016/j.addbeh.2019.04.020

Engberg, I., Segerstedt, J., Waller, G., Wennberg, P., & Eliasson, M. (2017). Fatigue in the general population- associations to age, sex, socioeconomic status, physical activity, sitting time and self-rated health: the northern Sweden MONICA study 2014. BMC Public Health, 17, 654. doi: 10.1186/s12889-017-4623-y

Exelmans, L., & Van den Bulck, J. (2016). Bedtime mobile phone use and sleep in adults. Social Science & Medicine, 148, 93-101. doi: 10.1016/j.socscimed.2015.11.037

Faul, F., Erdfelder, E., Lang, A-G., Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175-91. doi: 10.3758/bf03193146.

Gao, J., Zheng, P., Jia, Y., Chen, H., Mao, Y., Chen, S., … Dai, J. (2020). Mental health problems and social media exposure during COVID-19 outbreak. PLoS ONE, 15(4), e0231924. doi: 10.1371/journal.pone.0231924

Grimaldi-Puyana, M., Fernández-Batanero, J. M., Fennell, C., & Sañudo, B. (2020). Associations of objectively-assessed smartphone use with physical activity, sedentary behavior, mood, and sleep quality in young adults: A cross-sectional study. International Journal of Environmental Research and Public Health, 17(10), 3499. doi: 10.3390/ijerph17103499

Haider, S., Grabovac, I., Rieder, A., & Dorner, T. E. (2019). Depressive symptoms, lack of physical activity, and their combination towards health care utilisation frequency. International Journal of Environmental Research and Public Health, 16(23), 4697. doi: 10.3390/ijerph16234697

Ictech, B. (2019). Smartphones and Face-to-Face Interaction: Digital Cross-Talk During Encounters in Everyday Life. Symbolic Interaction, 42(1), 27-45. doi: 10.1002/symb.406

Jimoh, F., Lund, E. K., Harvey, L. J., Frost, C., Lay, W. J., Roe, M. A., … Finglas, P. M. (2018). Comparing diet and exercise monitoring using smartphone app and paper diary: A two-phase intervention study. JMIR mHealth and uHealth, 6(1), e17. doi: 10.2196/mhealth.7702

Kasza, J., & Wolfe, R. (2014). Interpretation of commonly used statistical regression models. Respirology, 19(1), 14-21. doi: 10.1111/resp.12221

Kircaburun, K., & Griffiths, M. D. (2018). Instagram addiction and the Big Five of personality: The mediating role of self-liking. Journal of Behavioral Addictions, 7(1), 158-170. doi: 10.1556/2006.7.2018.15

Kovacevic, A., Mavros, Y., Heisz, J. J., & Fiatarone Singh, M. A. (2018). The effect of resistance exercise on sleep: A systematic review of randomized controlled trials. Sleep Medicine Reviews, 39, 52-68. doi: 10.1016/j.smrv.2017.07.002

Kwon, M., Kim, D.-J., Cho, H., & Yang, S. (2013a). The smartphone addiction scale: Development and validation of a short version for adolescents. PLoS ONE, 8(12), e83558. doi: 10.1371/journal.pone.0083558

Kwon, M., Lee, J.-Y., Won, W.-Y., Park, J.-W., Min, J.-A., Hahn, C., ... Kim, D.-J. (2013b). Development and Validation of a Smartphone Addiction Scale (SAS). PLoS ONE, 8(2), e56936. doi: 10.1371/journal.pone.0056936

Landis, J. R., & Koch, G. G. (1977). The Measurement of Observer Agreement for Categorical Data. Biometrics, 33(1), 159-174. doi: 10.2307/2529310

Lipsky, L. M., Haynie, D. L., Hill, C., Nansel, T. R., Li, K., Liu, D., … Simons-Morton, B. (2019). Accuracy of Self-Reported Height, Weight, and BMI Over Time in Emerging Adults. American Journal of Preventive Medicine, 56(6), 860-868. doi:10.1016/j.amepre.2019.01.004

Liu, S., Xiao, T., Yang, L., & Loprinzi, P. D. (2019). Exercise as an alternative approach for treating smartphone addiction: A systematic review and meta-analysis of random controlled trials. International Journal of Environmental Research and Public Health, 16(20), 3912. doi: 10.3390/ijerph16203912

Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335-343. doi: 10.1016/0005-7967(94)00075-U

Mcnair, D. M., Lorr, M., & Droppleman, L. F. (1971). Manual for the Profile of Mood States. San Diego, CA: Educational and Industrial Testing Services. Retrieved from https://www.statisticssolutions.com/profile-of-mood-states-poms/

Mikkelsen, K., Stojanovska, L., Polenakovic, M., Bosevski, M., & Apostolopoulos, V. (2017). Exercise and mental health. Maturitas, 106, 48-56. doi: 10.1016/j.maturitas.2017.09.003

Passos, G. S., Poyares, D., Santana, M. G., DʼAurea, C. V. R., Youngstedt, S. D., Tufik, S., & de Mello, M. T. (2011). Effects of moderate aerobic exercise training on chronic primary insomnia. Sleep Medicine, 12(10), 1018-1027. doi: 10.1016/j.sleep.2011.02.007

Peluso, M. A. M., & Guerra de Andrade, L. H. S. (2005). Physical activity and mental health: the association between exercise and mood. Clinics (São Paulo, Brazil), 60(1), 61-70. doi: 10.1590/S1807-59322005000100012

Rohlfs, I. C. P. D. M., Rotta, T. M., Luft, C. D. B., Andrade, A., Krebs, R. J., & De Carvalho, T. (2008). Brunel mood scale (BRUMS): An instrument forearly detectionof overtraining syndrome. Revista Brasileira de Medicina Do Esporte, 14(3), 176-181. doi: 10.1590/S1517-86922008000300003

Roth, F., & Brönnimann, G. (2013). Focal Report 8: Risk Analysis Using the Internet for Public Risk Communication (pp. 5-24). Risk and Resilience Research Group, Center for Security Studies (CSS), ETH Zürich. Retrieved from https://www.research-collection.ethz.ch/bitstream/handle/20.500.11850/73314/eth-7416-01.pdf

Sinclair, S. J., Siefert, C. J., Slavin-Mulford, J. M., Stein, M. B., Renna, M., & Blais, M. A. (2012). Psychometric Evaluation and Normative Data for the Depression, Anxiety, and Stress Scales-21 (DASS-21) in a Nonclinical Sample of U.S. Adults. Evaluation & the Health Professions, 35(3), 259-279. doi: 10.1177/0163278711424282

Solon Júnior, L. J. F., Fortes, L. S., Barbosa, B. T., Feitosa Júnior, J. V. A., Ribeiro, C. H. T., & Silva Neto, L. V. (2020). Home-based exercise during confinement in CO-VID-19 pandemic and mental health in adults: a cross-sectional comparative study. Revista Brasileira de Atividade Fisica & Saúde, 25, 1-7. doi: 10.12820/rbafs.25e0120

Troyer, E. A., Kohn, J. N., & Hong, S. (2020). Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? Neuropsychiatric symptoms and potential immunologic mechanisms. Brain, Behavior, and Immunty, 87, 34-39. doi: 10.1016/j.bbi.2020.04.027

Vignola, R. C. B., & Tucci, A. M. (2014). Adaptation and validation of the depression, anxiety and stress scale (DASS) to Brazilian Portuguese. Journal of Affective Disorders, 155, 104-109. doi: 10.1016/j.jad.2013.10.031

Voitsidis, P., Gliatas, I., Bairachtari, V., Papadopoulou, K., Papageorgiou, G., Parlapani, E., … Diakogiannis, I. (2020). Insomnia during the COVID-19 pandemic in a Greek population. Psychiatry Research, 289, 113076. doi: 10.1016/j.psychres.2020.113076

Weinstein, A., & Lejoyeux, M. (2015). New developments on the neurobiological and pharmaco-genetic mechanisms underlying internet and videogame addiction. American Journal on Addictions, 24(2), 117-125. doi: 10.1111/ajad.12110

World Wide Web Foundation. (2020). The web can help more in the fight against Covid-19. Hereʼs what we must do. News and Blogs. Retrieved from https://webfoundation.org/2020/03/the-web-can-help-more-in-the-fight-against-covid-19-heres-what-we-must-do/

Xu, T. T., Wang, H. Z., Fonseca, W., Zimmerman, M. A., Rost, D. H., Gaskin, J., & Wang, J. L. (2019). The relationship between academic stress and adolescentsʼ problematic smartphone usage. Addiction Research & Theory, 27(2), 162-169. doi: 10.1080/16066359.2018.1488967

Yang, Y., & Koenigstorfer, J. (2020). Determinants of physical activity maintenance during the Covid-19 pandemic: a focus on fitness apps. Translational Behavioral Medicine, 10(4), 835-842. doi: 10.1093/tbm/ibaa086