What is ‘problematic smartphone use’ and should we worry about it?

Two recent studies have linked “problematic smartphone use” among teenagers to increased symptoms of anxiety, depression and insomnia. But is it a real problem? And how worried, if at all, should we be?

What is “problematic smartphone use”?

The researchers of both studies defined smartphone use as being “problematic” if it involves someone losing their sense of control over usage, being preoccupied with their device at the expense of meaningful activities and feeling distressed when they can’t use it. Use becomes problematic when it interferes with your work, school or relationships, says Jon Elhai at the University of Toledo in Ohio, who wasn’t involved in either study.

“Problematic smartphone use” isn’t recognised as a diagnosable condition by official health bodies, such as the World Health Organization, the US Centers for Disease Control and Prevention or the national health services in the UK.

The two pieces of work found an association with certain conditions. This means additional research is needed to ascertain if smartphone use can cause such health problems, says Nicola Kalk at King’s College London, who was involved in both studies.

What did the two studies find?

In one, Kalk and her colleagues surveyed smartphone use among more than 650 teenagers, aged 16 to 18. They used the “Smartphone Addiction Scale”, which asks whether people experience blurred vision due to their device use or if they feel impatient when not holding it, for example. This leads to a score from 10 to 60, with scores above 30 considered problematic.

Of the participants, 19 per cent met the definition of problematic smartphone use. These individuals were twice as likely to report symptoms of moderate anxiety and nearly three times as likely to report symptoms of moderate depression, compared with their peers.

On average, those with problematic smartphone use spent an extra 29 minutes per day on Instagram and 22 minutes more on TikTok, compared with those without problematic smartphone use. There were no links between problematic smartphone use and other apps, such as Snapchat or WhatsApp.

The team accounted for factors that may influence the results, such as how long the participants said they spent on their smartphones each day. “We [also] teased apart the impact of [general] screen time from the effects of problematic smartphone usage, and while screen time was not linked to anxiety or depression, problematic smartphone usage was,” says Kalk.

In the second study, a different team surveyed smartphone use among 69 teenagers aged 13 to 16, along with their prevalence of anxiety, depression and insomnia symptoms. The researchers found that 44 per cent of the participants met the definition of problematic smartphone use, based on the same addiction scale.

When the team surveyed 62 of the participants again a month later, they found an increase in the severity of problematic smartphone use over that time was linked to more severe symptoms of anxiety, depression and insomnia.

Should we worry about “problematic smartphone use”?

These studies are small and don’t prove that what is considered problematic smartphone use actually causes declines in teen mental health, says Sunny Xun Liu at Stanford University.

Kalk and Ben Carter at King’s College London, who was involved in both studies, acknowledge that young people who are already experiencing these symptoms may use their smartphones in a more problematic way than people without mental health issues. “It may be a bidirectional link, but we can’t yet say whether it’s causal,” says Jay Olson at the University of Toronto in Canada.

For example, people with pre-existing depression symptoms may be more reliant on their phone than someone without the condition if they take comfort from communicating with loved ones, while someone with insomnia may depend on their phone to battle boredom in the middle of the night.

In the second study, the participants with signs of problematic smartphone use were five times more likely to say they wanted to cut down on their device use than those without such usage. The fact that these teenagers want to use their phones less makes the results “both worrying and also positive”, says Carter.

How can we reduce our smartphone use if we’re concerned?

Surveys of participants from the first study revealed that 95 per cent of them had tried to limit their smartphone use. They said that the most effective strategies were occasionally putting their device on “do not disturb” mode, turning off notifications and leaving it in another room at bedtime.

Rather than imposing restriction on teenagers’ phone use, parents and schools should have discussions with them about what aspects of smartphone use are benefitting or harming them, says Kalk. For example, some of the teens reported enjoying keeping in touch with loved ones via their smartphones, but also that they could be distracting.