The article’s thesis statement:

purpose of research:

method(s) used to gather valid evidence to support the thesis statement:

evidence and reasoning used to support thesis statement:

How source fits into research / how it will be used

Kiara Ramon-Lozano

Dr. Sharity Nelson

ENGL 1302-231

26 January 2024

The Correlation Between Mental and Emotional Wellness and Smartphone Use in University

Students: An Annotated Bibliography

1. Abuhamdah, Sawsan M. A., and Abdallah Y. Naser. “Smartphone Addiction and Its

Mental Health Risks among University Students in Jordan: A Cross-Sectional Study.”

BMC Psychiatry, vol. 23, no. 812, 2023, pp. 1-9, Academic Search Complete,

https://doi.org/10.1186/s12888-023-05322-6.

Abuhamdah and Naser studied the pervasiveness of mobile phone dependence and emotional

turmoil in 2,337 Jordanian university students to determine if people with particular

demographics and mindsets are more susceptible to problematic smartphone use and mental

instability (3). In an online survey, participants disclosed demographic information then

responded to two questionnaires– including the Kessler Psychological Distress Scale and

Smartphone Addiction Scale––to determine the likelihood and severity of “mental disorder” and

mobile phone addiction (2). If the sum of a student’s SAS responses surmounted 30 points on a

scale from 10 to 60, they were considered to have adopted a dependence on their mobile device;

based on Kessler’s scale, those who scored above 30 points on a scale from 10 to 50 were
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considered to be severely emotionally distressed (3). 59.1% of participants experienced “severe

psychological distress” and 56.7% were considered addicted to their cell phones (3-4).

Abuhamdah and Naser concluded that female students who reported feeling lethargic and

claimed that their mobile phone use worsened their ability to sleep and think were more likely to

experience a “severe mental disorder” and mobile phone addiction (6). These results suggest that

there is a correlation between “mental health” and “smartphone addiction” and highlights their

frequency in undergraduates.

by using self-report questionnaires for both to

concluded that female participants who who denotes the extent of as were added up to and

Students whose Kessler questionnaire results were classified as mentally healthy, above 30 on

were considered to be participants Abuhamdah and Naser then concluded that was likely and

measured interpret stress by building a “psychological distress profile” and participants from

“universities in Jordan” and evaluated the students’ level of “psychological distress” and the

severity of “smartphone addiction” via online survey (1). 1: Online survey study using the

“Kessler psychological distress scale” and “Smartphone Addiction Scale” 59.1% “severe mental

disorder state” 2: Thesis: “[S]mart phone addiction can also cause mental, behavioral, and

social issues… causes attention deficit and maladaptive behavior issues, interferes with school

and employment, lowers performance in school, and decreases in-person social contacts [18].”

Purpose: “[T]his study aims to explore the prevalence of smart phone addiction, its associated

psychological distress risk, and its associated predictors among university students in Jordan.”

This study demonstrates that college students are susceptible to both excessive smartphone use

and *psychological distress* (#). Additionally, Abuhamdah and Naser concluded that
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demographics can indicate whether students are more likely to experience problematic

smartphone use and *psychological distress* (4-5).

2023 - Jordan University students - “mental health risks” - This study was only open to those

who had access to Facebook or WhatsApp and those who can feasibly understand Arabic.

speak/understand Arabic,” sent invitation to study on WhatsApp and Facebook, sample was

composed of “majority female”

2. Chen, Baifeng, et al. “Gender Differences in Factors Associated with Smartphone

Addiction: A Cross-Sectional Study among Medical College Students.” BMC Psychiatry,

vol. 17, no. 341, 2017, pp. 1-9. Academic Search Complete,

https://doi.org/10.1186/s12888-017-1503-z.

Chen et al. evaluated the role of gender in problematic smartphone use through surveying 1,441

undergraduate students at a Chinese medical university (2). Participants detailed the most

common reasons for their mobile phone use and completed questionnaires that separately

measure “anxiety and depression symptoms” and mobile phone “addiction” (2). Students’ survey

responses were transferred to SPSS where factors were analyzed individually and compared to

other pieces of data to identify possible correlations between variables (3). This study was

limited to undergraduates from one university and was not longitudinal, meaning that its findings

cannot be universally assumed true (7-8). Chen et al. discovered that men who use their

smartphones for mobile games and women who use their phones for social media are more

susceptible to smartphone addiction, noting that smartphone addiction is more prevalent among

men (7). This study conducted by Chen et al. has a contradicting viewpoint when compared to
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previous studies evaluating gender differences among smartphone users and suggests a

connection between two common mental disorders and smartphone dependence.

Additionally, although other studies concluded that women, this study suggests that there is a

higher occurrence of smartphone addiction in men, which not only stresses that further study on

the impact gender has on smartphone use is necessary but also provides a contradictory

viewpoint to other studies. a difference between the reason men use their smartphone and the

reason women use their smartphone (). Impact of gender differences on smartphone use

MEDICAL COLLEGE students

3. Ercengiz, Mustafa, et al. “Differentiation of Self, Emotion Management Skills, and

Nomophobia among Smartphone Users: the Mediating and Moderating Roles of

Intolerance of Uncertainty.” The Social Science Journal, 2020, pp. 1-15. Taylor &

Francis Online, https://doi.org/10.1080/03623319.2020.1833148.

Nomophobia–known as the fear of being without a smartphone–is said to persist in modern

society (2). Ercengiz et al. evaluated how the severity of nomophobia of 398 Turkish college

students was impacted by their ability to regulate their “emotions” when faced with

unpredictability, social pressures, and daily stressors (2-4). Participants answered a nomophobia

survey and a questionnaire for each of the psychological factors evaluated (6). Ercengiz et al.

reported that individuals with a greater capacity for independent thought were less likely to

display nomophobic tendencies; furthermore, those who struggle to be independent and cope

with unpredictability were more likely to experience nomophobia (2). Data was self-reported at a

particular point in time, so this study alone cannot verify the relationships above, and it is subject

to the researchers’ creation biases (11). Ercengiz et al. argue that the inability to cope with
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unpredictability explains how “interpersonal” and internal insecurity can develop into

smartphone anxiety (3). These findings provide a foundation for further research on the causes of

nomophobia and suggest that those who have social and mental health issues are more likely to

develop an additional psychological issue: nomophobia.

(often anxious individuals) are (confirmed: “Hypothesis 1: Differentiation of self predicts

nomophobia negatively and significantly. Hypothesis 2: Intolerance of uncertainty has a

mediating role in the relationship between the differentiation of self and nomophobia.”

moderating : direction and/or strength of the relationship between an independent

(predictor) variable and a dependent (criterion) variable. mediating : explains the

relationship between the dependent variable and the independent variable; mediator

variable explains how the external physical events affect the internal psychological

significance

insert #* was confirmed, each relating nomophobia to “emotion management,” “differentiation

of self,” and “intolerance of uncertainty” (). This study administered a series of surveys–one for

each factor evaluated–to each participant (). Using Based on the results of the Third hypothesis

was not confirmed (8), 6th hypothesis was not confirmed (9), “Self-differentiation” Found that

based on uncovering the causes of nomophobia by analyzing the psychological state of its

participants through multiple surveys. . UNIVERSITY STUDENTS IN TURKEY - “emotion

management skills” - multiple hypothesis

4. Hashemi, Shima, et al. “Investigate the Relationship Between Cell-Phone Over-Use

Scale with Depression, Anxiety and Stress among University Students.” BMC Psychiatry,
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vol. 22, no. 755, 2022, pp. 1-9. Academic Search Complete,

https://doi.org/10.1186/s12888-022-04419-8.

Hashemi et al. studied the correlation between poor mental health and problematic smartphone

use in undergraduate and graduate students attaining science degrees in Iran (3). Hashemi et al.

open the paper by discussing the increasing number of people who use “technology” and

“smartphones” and the implications that may result from excessive use in individuals of all ages

(2). Hashemi et al. administered the Depression, Anxiety, and Stress Scale (DASS-21) and

Cell-phone Over-Use Scale (COS) surveys to 212 students (3). According to the COS, those who

score more than 75 points use their phone more often than necessary, while those who scored

less than 25 points rarely used their phone (3). The DASS-21 has one section for each of the

three aspects of psychological health being evaluated with scales results ranging from normal to

extremely severe (3). The data from both tests was interpreted through a statistics software

program to avoid errors, but data was subject to participant’s biases when reporting their

symptoms (3). Other limitations include the narrow range of participants and lack of longitudinal

study (7). Hashemi et al. concluded that the more one “overuses” their phone, the more likely

they are to experience symptoms of “stress and anxiety;” thus, smartphone addiction is likely a

cause of emotional distress (7). These findings demonstrate a need for awareness and

intervention regarding smartphone “overuse” in college students to prevent harm to their mental

health.

5. Kuru, Tacettin, and Sinem Çelenk. “The Relationship Among Anxiety, Depression, and

Problematic Smartphone Use in University Students: The Mediating Effect of

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Psychological Inflexibility.” Alpha Psychiatry, vol. 22, no. 3, 2021, pp 159-164.

Academic Search Complete, https://doi.org/10.5455/apd.136695.

Kuru and Çelenk tested two hypotheses that investigate whether “psychological inflexibility”

elucidates the relationship between anxiety and depression and excessive mobile phone “use” in

Turkish 412 college students (160). The purpose of this study was to understand potential causes

of “PSU” to inspire an effective means of intervention for college students who suffer from

mental health issues and struggle to limit their smartphone use as a result (162). Participants

responded to four Lickert scale questionnaires to measure their mental health and intensity of

“smartphone addiction” and “psychological inflexibility” (160). As hypothesized, anxiety

“predicts PSU” and has an indirect effect on “psychological inflexibility” which indirectly causes

increases in excessive mobile phone use (161). Similarly, the correlation between depression and

“PSU” is present individually, but the two variables are more closely related when

“psychological inflexibility” is present (161-162). Kuru and Çelenk refers to a figure that

clarifies the indirect and direct correlations found between variables (161). Besides the fact that

self-report biases are associated with the data collected and the transverse nature of this study,

Kuru and Çelenk address that the survey used to measure “psychological inflexibility” minimizes

a few aspects of this behavioral pattern (163). This study demonstrates a relevant pattern to target

when treating anxious and depressed college students who struggle with cell phone addiction and

overuse.

problematic smartphone use is significant because it the relevance of the mediating variable

suggested “mediating role” in the “relationship” between anxiety and PSU and depression and

PSU ().
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When learning about mediator vs. moderator variables, understand that meeting the following

conditions makes a mediation analysis feasible:

- The independent variable must cause the mediator

- The mediator must influence the dependent variable

- The mediator must cause a higher statistical correlation between dependent and

independent variables

- Turkish University students - “Anxiety… depression… Psychological Inflexibility”

6. Liu, Fengbo, et al. “Effectiveness of Brief Mindfulness Intervention for College Students’

Problematic Smartphone Use: The Mediating Role of Self-Control.” PLoS ONE, vol. 17,

no. 12, 2022, pp. 1-13. Academic Search Complete,

https://doi.org/10.1371/journal.pone.0279621.

“Problematic smartphone use” is a global occurrence that gives rise to physical and mental health

concerns, especially in China (2). As a result, Liu et al. conducted a controlled experiment on 44

undergraduates from a Chinese university to assess whether a half-hour implementation of a

form of cognitive-behavioral therapy can reduce excessive cell phone use, either directly or

indirectly (5). Before and after their sessions, students filled out three Likert-scale surveys that

separately measured their discipline level, mobile phone dependence, and capacity for awareness

and acceptance (4-5). Participants either experienced “mindful breathing and body

scanning”–experimental group–or listened to news reports–control group (5). Liu et al.

separately compared pre- and post-assessment data of both groups; they then compared the

correlation of the variables studied and observed changes in mindset between the experimental
 Ramon-Lozano 9

and control groups (5). Liu et al. correctly hypothesized that minutes of mindfulness treatment

decreases cell phone addiction by developing “self-discipline” (3-4). Nonetheless, this study

cannot definitively claim that “mindfulness” has lasting effects on cell phone use because data

was self-reported and few students participated (10). Liu et al.’s study is unique, for it suggests

that individuals who overuse their smartphone can alleviate or reduce their addiction through

non-time-consuming approaches.

it does not simply suggest that individuals with particular traits are more susceptible to

overusing their cell phone; rather, post-assessments were administered immediately after

exposure to “mindfulness” ; then, the three surveys were re-administered as a post-assessment

and that improvements in “self-discipline” explain how “brief mindfulness” decreases “phone

use”, these comparison between the control and experimental group was then collected from

demonstrate the effects of “increase one’s self-awareness/mindfulness”, which builds on previous

research that observes the differences in smartphone use amongst people with varying levels of

mindfulness (). increasing restraint whether IMPROVE ONE’S EXISTING

CONDITION/ADDICTION RATHER THAN SIMPLY STATING THAT PEOPLE WHO ARE

MORE MINDFUL USE THEIR PHONE LESS broaden what the unknowns behind this research

topic since many studies only observe the (). the importance of furthering research that not only

observes “smartphone addiction” and increasing their impulsivity created their study to introduce

their study by noting the prominence of mobile phone addiction worldwide and the This

experiment packs a harder punch than previous research, for it evaluates whether “short

mindfulness practices” have the potential to lessen “problematic smartphone use” in “at risk

populations”, like adolescents and college students (). *who did not receive mindfulness
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training* and an experimental group *who met for mindfulness training X amount of time*

Although this study was, Acknowledging the discourse - Chinese college students -

“Mindfulness” to prevent PSU

With mindfulness, we learn to recognize and acknowledge what's going on in the mind,

moment by moment, without judgment and with benevolence, and to let it go. With awareness,

we use our awareness of the thoughts, emotions and sensations that arise in the mindstream as

the actual focal point of the meditation.

7. Mohamed, Zaibab K., et al. “Smartphone Addiction and Its Relation to Social Phobia in

Female University Students.” Middle East Current Psychiatry, vol. 30, no. 74, 2023, pp.

1-10. Academic Search Complete, https://doi.org/10.1186/s43045-023-00327-z.

Mohamed et al. interviewed 540 female undergraduates from various disciplines to evaluate

whether social anxiety disorder can predict mobile phone dependence (2). Medical professionals

conducted a one-hour interview with each participant to verify that they did not have a mental

health issue according to the Diagnostic and Statistical Manual of Mental Disorders and to

prevent other factors from altering results; in a second interview, students responded to the

Social Phobia Inventory and Smartphone Addiction Scale questionnaires (3). Mohamed et al.

found that nearly 50% of students had mild or moderate social anxiety and roughly a quarter of

students had a severe form of social anxiety; moreover, students attaining degrees in fields that

require hands-on experience were less likely to be mobile phone-dependent and had less students

with severe social anxiety (5). Despite what students’ selected course of study, higher social

anxiety levels were correlated with higher levels of cell phone addiction (6). Mohamed et al.’s

study is pertinent because it explores how students’ selected major may relate to excessive
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smartphone use, and thus mental health issues, while also contributing background knowledge

for future longitudinal study of cell phone dependence.

2023 - female university students - “social phobia”/social anxiety and smartphone use wand to

gauge the intensity of prevalence of and correlation between cell phone dependence and “social

anxiety” and

8. Squires, Lauren R., et al. “Psychological Distress, Emotion Dysregulation, and Coping

Behaviour: a Theoretical Perspective of Problematic Smartphone Use.” International

Journal of Mental Health and Addiction, vol. 19, no. 4, 2021, pp. 1284-1299. Academic

Search Complete, https://doi.org/10.1007/s11469-020-00224-0.

Squires et al. studied the impact of emotional processing on poor mental health and mobile

phone overuse in 204 Canadian college students (1289). The researchers claim that the existing

studies on cell phone addiction and overuse cannot verify or deny the correlations suggested

because of their limitations, so they aimed to evaluate whether these assumptions can lay a

foundation for further study in a broader context (1285-86). Students filled out an online survey

that consisted of the Difficulties in Emotion Regulation Scale-18, Depression Anxiety and Stress

Scale-21, and Smartphone Addiction Scale-Short Version (1290). Squires et al. hypothesized that

increases in symptoms of “psychological distress” and worsens one’s ability to cope with their
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emotional responses, which results in the individual using their phone in excess–possibly to

avoid confronting unpleasant thoughts (1287-88). Squires et al. created a figure that is

harmonious with the results of this study and similar research that models the suggested

mediating effect of DERS-18 scores on DASS-21 and SAS-SV scores (1293). This study

acknowledges the shortcomings of current research and emphasizes the similarities between

“problematic mobile phone use and problematic Internet use” (1294-95).

on the assumed relationships between Additionally, based their study on notion that

Demonstrated the relevance of their experiment by - Canadian Undergrad students - “Depression

Anxiety and Stress”

9. Yadav, Shiv K., et al. “A Study to Evaluate Pattern and Purpose of Smartphone Usage

and Its Dependence among Medical Students of Government Medical College in

Northern India.” Indian Journal of Community Health, vol. 34, no. 1, 2022, pp. 36-41.

Academic Search Complete, https://doi.org/10.47203/IJCH.2022.v34i01.008.

Yadav et al. surveyed 363 students attaining their bachelor’s degree in medicine and surgery in

India to observe the prominence of cell phone reliance and identify potential reasons for overuse

(37). Participants completed the nomophobia questionnaire and answered questions regarding

their demographics, common reasons for phone use, and frequency of messaging, calling,

emailing, etc (37-38). Yadav et al. included a table and four figures that summarize and organize

the data collected (40-41). 93% of students used their phones out of boredom, 60% had a daily

screen time of more than 3 hours on their phone alone, and over 90% had a moderate to extreme

cell phone addiction (38, 40). Yadav et al. found that nomophobia questionnaire scores were

correlated with students’ year of study and the amount of messages and calls they send and
 Ramon-Lozano 13

receive (38). This study suggests potential predictors of nomophobia and cell phone addiction in

medical students which could be the focus of future, longitudinal studies.

2022 - prevalence of smartphone addiction among “medical students”

10. Yang, Xiaofan, et al. “Perceived Social Support, Depressive Symptoms,

Self-Compassion, and Mobile Phone Addiction: A Moderated Mediation Analysis.”

Behavioral Sciences, vol. 13, no. 9, 2023, pp. 1-13. Academic Search Complete,

https://doi.org/10.3390/bs13090769.

Yang et al. surveyed 874 undergraduate students in China to investigate how their cell phone

dependence and the assumed strength of their support systems are affected by their “depressive

symptoms” and “self-compassion” (3-4). Students responded to the Perceived Social Support

Scale, Mobile Phone Addiction Index, Depression-Anxiety-Stress Scale, and Self-Compassion

Short Form surveys online to assess their symptoms (4-5). Yang et al. tested their study for

biases that may result because of participants’ self-reported symptoms, but they determined that

it did not have an overwhelming statistical impact on their study (5). As summarized in a figure,

it was hypothesized that kindness toward oneself may lessen the risk of “depressive symptoms”

and “cell phone dependence” (4). Yang et al. concluded that students with a weaker support

system were more susceptible to “symptoms of depression,” which may result in cell phone

reliance; in addition, support systems only played a significant role in cell phone addiction if

students’ kindness toward themselves was low (8-9). The conclusions of this study suggest that

college students’ smartphone addictions and mental health issues are correlated, and, for those

who lack “self-compassion,” addiction is not solely dependent on internal factors.

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- University Students - “Social Support, Depressive Symptoms, Self-Compassion” AND

smartphone addiction