Abstract
Background:
Nomophobia is a portmanteau for “no mobile phone” and phobia or mobile phone addiction. Nomophobia refers to discomfort, anxiety, nervousness, or anguish caused by being out of contact with a mobile phone. There is a paucity of literature from India on this emerging mental health condition.
Objectives:
The objectives of this study were to assess the prevalence of nomophobia and its relationship with depression, anxiety, and quality of life among adolescent students.
Materials and Methods:
A cross-sectional study was carried out in 1386 high school students aged between 14 and 17 years. The Nomophobia Questionnaire (NMP-Q) was used to assess nomophobia. Beck’s Depression Inventory (BDI), Beck’s Anxiety Inventory (BAI), and Short Form-36 (SF-36) were used to measure depression, anxiety, and quality of life, respectively.
Results:
Out of 1386 adolescents, 569 (41.05%), 303 (21.86%), and 82 (5.1%) have mild, moderate, and severe nomophobia, respectively. There were significantly more males with nomophobia. There was a statistically significant relationship between NMP-Q score and BDI, BAI, and SF-36 scores. A significant positive correlation was observed between NMP-Q score and scores on BDI and BAI and a significant negative correlation between SF-36 score.
Conclusion:
The results of the study indicate that nomophobia is an emerging mental health condition, especially in male adolescents. Nomophobia is significantly associated with depression, anxiety, and poor quality of life. Multicentric studies are needed to better understand this disorder.
Keywords: Adolescents, anxiety, depression, mobile phone, nomophobia, quality of life
Nomophobia (a portmanteau for “no mobile phone” and phobia)[1,2,3,4,5] refers to discomfort, anxiety, nervousness, or anguish caused by being out of contact with a mobile phone.[2] The use of smartphones has increased, and this has made smartphone addiction a significant public health concern in recent years.[2] Nomophobia is considered a disorder of the contemporary digital and virtual society.[3] In general, it is the pathological fear of remaining out of touch with technology. The portable smartphones allow for shorter use periods of multiple internet-based mobile applications (“apps”) in contrast to relatively long periods of computer-based internet use. Smartphone addiction has been considered to be a technological addiction, which is defined as behavioral addictions of a nonchemical nature that involve human–machine interaction.[5]
Surveys performed in different countries and cultures[6,7,8,9,10] indicate that nomophobia is universally widespread and present. Recent literature has drawn on addiction symptoms to measure problematic,[11] compulsive,[12] heavy,[13] intensive,[14] maladaptive,[15] dependent,[16] and addictive tendencies[17] for mobile phone uses. The use of smartphones has both positive and negative impacts on the lives of people across the globe. However, studies examining the effect of nomophobia on quality of life in adolescents are limited.
Although there has been an increasing academic interest in investigating the problems emanating from smartphone use, research into nomophobia has been scarce.[18,19] A study involving high school students reported the prevalence of mobile phone dependence in adolescents to be 31.3%.[20] Most Indian studies[21,22,23] on nomophobia have been conducted on adults and are limited by small sample sizes and variability in tools employed. India is one of the largest markets for smartphones, and adolescents are major consumers. Despite this, there is a paucity of Indian literature with regard to nomophobia and its impact on mental health. The present study aims to study the prevalence of nomophobia and its relationship with depression, anxiety, and quality of life in adolescents.
MATERIALS AND METHODS
The present study was conceptualized and data analysis was conducted in the department of psychiatry of a medical college in Rajasthan, India. The study protocol was approved by the institutional ethics committee. After obtaining permission from the principals, students of class 11 and 12 of seven private coeducational schools with English medium of instruction in an urban area of a major city in the state of Rajasthan, India, were invited to participate in this survey conducted in December 2016. The students were assembled with the help of school authorities and appraised regarding the objectives and method of the study by the principal author during the recess period. Students possessing a smartphone and willing to participate in the study were included. Written informed assent for the study was obtained from the participants. The parents/guardians of the students were contacted via E-mail, and their written informed consent was obtained. The study tools used were in English and of pencil–paper type. The principal author was present to provide clarifications to the participants and made the requisite number of visits to the school in order to collect data from all consenting students. The data obtained were recorded in a specific pro forma prepared for the study. Correspondence with the parent/guardian of eight students could not be made, and three students refused to participate in the study. A total of 1386 students were surveyed.
The Nomophobia Questionnaire (NMP-Q)[24] was used to assess nomophobia. This is a twenty item self-reported questionnaire with a Likert scale rating. The overall internal consistency of the questionnaire has been reported to be very good (Cronbach’s alpha = 0.945).[24] The scores on the NMP-Q and the Mobile Phone Involvement Questionnaire[25] were strongly correlated, which indicated that two questionnaires measured similar constructs and ensured the construct validity of the NMP-Q.[24] The qualitative data analysis[24] revealed four dimensions of nomophobia, namely not being able to communicate, losing connectedness, not being able to access information, and giving up convenience. Adolescents were classified into mild nomophobia (NMP-Q score of 21–59), moderate nomophobia (NMP-Q score: 60–99), and severe nomophobia (NMP-Q score: >100).
Beck’s Depression Inventory (BDI),[26] Beck’s Anxiety Inventory (BAI),[26,27] and Short Form-36 (SF-36)[28,29] were used to measure depression, anxiety, and quality of life, respectively. These tools have been found to be psychometrically sound measures for the abovementioned constructs in adolescents.[28,29,30] The data obtained were analyzed using the Statistical Package for the Social Sciences for Windows, version 16 (SPSS Inc., Chicago, IL, USA).[31]
RESULTS
The average age of the study population was 15.5 years. There were 928 (67%) males and 458 (33%) females [Table 1]. Majority of the adolescents were from class 11 (50.5%), residing in urban areas (82.7%) in nuclear families [Table 1]. Out of 1386 adolescents, 569 (41%), 303 (21.9%), and 82 (5.9%) have mild, moderate, and severe nomophobia, respectively [Table 1]. There were significantly more males with nomophobia in comparison to females [Table 2]. No significant relationship was observed with other sociodemographic variables.
Table 1.
Sample characteristics of the study population
| Profile (n=1386) | Variables | Frequency (%) |
|---|---|---|
| Age (years) | 14 | 6 (00.43) |
| 15 | 143 (10.31) | |
| 16 | 547 (39.47) | |
| 17 | 690 (49.79) | |
| Gender | Male | 928 (66.96) |
| Female | 458 (33.04) | |
| Education | 11th | 701 (50.58) |
| 12th | 685 (49.42) | |
| Religion | Hindu | 1218 (87.88) |
| Muslim | 74 (5.33) | |
| Christian | 36 (2.59) | |
| Others | 58 (4.20) | |
| Location of residence | Urban | 1147 (82.76) |
| Rural | 209 (15.08) | |
| Others | 30 (2.16) | |
| Family size | <5 | 803 (57.94) |
| 5-10 | 500 (36.07) | |
| >10 | 83 (5.99) | |
| Type of family | Nuclear | 785 (56.64) |
| Joint | 465 (33.55) | |
| Extended | 136 (9.81) | |
| NMP-Q score (intensity of nomophobia) | <21 (no) | 432 (31.2) |
| 21-59 (mild) | 569 (41) | |
| 60-99 (moderate) | 303 (21.9) | |
| >100 (severe) | 82 (5.9) |
NMP-Q – Nomophobia Questionnaire
Table 2.
Gender distribution of nomophobia scores
| Gender | NMP-Q score, n (%) | Chi-square statistic | |||
|---|---|---|---|---|---|
| No | Mild | Moderate | Severe | ||
| Male | 230 (24.8) | 396 (42.7) | 234 (25.2) | 68 (7.3) | χ2=62.423, df=3, P<0.001 |
| Female | 202 (44.1) | 173 (37.8) | 69 (15.1) | 14 (3.1) | |
NMP-Q – Nomophobia Questionnaire
There is a significant relationship between NMP-Q score and BDI score (P < 0.05) and BAI score (P < 0.001) [Tables 3 and 4]. A significant relationship is observed between NMP-Q score and SF-36 score (P < 0.001) [Table 5].
Table 3.
Relationship between nomophobia and depression in adolescent students
| NMP-Q score (n=1386) | BDI score (n=1386) | Chi-square statistic | |||
|---|---|---|---|---|---|
| 0-13 (nil) | 14-19 (mild) | 20-28 (moderate) | 29-63 (severe) | ||
| No <21 | 335 (77.5) | 54 (12.5) | 34 (7.9) | 9 (2.1) | χ2=19.783, df=9, P<0.019 |
| Mild 21-59 | 432 (75.9) | 77 (13.5) | 49 (8.6) | 11 (1.9) | |
| Moderate 60-99 | 198 (65.3) | 58 (19.1) | 34 (11.2) | 13 (4.3) | |
| Severe >100 | 55 (67.1) | 14 (17.1) | 11 (13.4) | 2 (2.4) | |
| Total | 1020 (73.6) | 203 (14.6) | 128 (9.2) | 35 (2.5) | |
NMP-Q – Nomophobia Questionnaire; BDI – Beck’s Depression Inventory
Table 4.
Relationship between nomophobia and anxiety in adolescent students
| NMP-Q score (n=1386) | BAI score (n=1386), n (%) | Chi-square statistic | |||
|---|---|---|---|---|---|
| 0-9 (nil) | 10-16 (mild) | 17-29 (moderate) | 30-63 (severe) | ||
| No <21 | 251 (58.1) | 97 (22.5) | 79 (18.3) | 5 (1.2) | χ2=130.615, df=9, P<0.001 |
| Mild 21-59 | 235 (41.3) | 176 (30.9) | 136 (23.9) | 22 (3.9) | |
| Moderate 60-99 | 94 (31.0) | 82 (27.1) | 99 (32.7) | 28 (9.2) | |
| Severe >100 | 16 (19.5) | 13 (15.9) | 41 (50.0) | 12 (14.6) | |
| Total | 596 (43.0) | 368 (26.6) | 355 (25.6) | 67 (4.8) | |
NMP-Q – Nomophobia Questionnaire; BDI – Beck’s Depression Inventory
Table 5.
Relationship between nomophobia and quality of life in adolescent students
| NMP-Q score | SF-36 score, n (%) | Chi-square statistic | |
|---|---|---|---|
| <1800 | >1800 | ||
| No <21 | 25 (5.8) | 407 (94.2) | χ2=36.200, df=3, P<0.001 |
| Mild 21-59 | 50 (8.8) | 519 (91.2) | |
| Moderate 60-99 | 41 (13.5) | 262 (86.5) | |
| Severe >100 | 21 (25.6) | 61 (74.4) | |
| Total | 137 (9.9) | 1249 (90.1) | |
NMP-Q – Nomophobia Questionnaire; SF-36 – Short Form-36
A significant positive correlation was observed between NMP-Q score and scores on BDI and BAI. A significant negative correlation was found between NMP-Q score and SF-36 score [Table 6].
Table 6.
Correlation between nomophobia, depression, anxiety, and quality of life in adolescent students (n=1386)
| NMP-Q score | |
|---|---|
| BDI score | |
| Pearson correlation | 0.141 |
| Significance (two-tailed) | <0.001 |
| BAI score | |
| Pearson correlation | 0.305 |
| Significance (two-tailed) | <0.001 |
| SF-36 score | |
| Pearson correlation | −0.191 |
| Significance (two-tailed) | <0.001 |
NMP-Q – Nomophobia Questionnaire; BDI – Beck’s Depression Inventory; SF-36 – Short Form-36; BAI – Beck’s Anxiety Inventory
DISCUSSION
The concept of behavioral addiction has received attention of researchers, and it has been considered to be equivalent to substance dependence as understood by the current nosological systems.[11,21,32] Nomophobia has been referred to as mobile phone dependence, mobile phone problematic use, problem cell phone use, and mobile phone abuse.[14,33,34,35,36]
Not much is known about the psychological bases of mobile phone behavior of young people. Studies indicate that it is younger people whose mobile phone behavior is most likely to resemble an addictive pattern of behavior.[37] For this reason, this cross-sectional study aimed to study the prevalence of nomophobia in adolescents attending private schools of Udaipur city in Rajasthan, India. To our knowledge, this is the first such study reported from north-western India.
Our study found 41% of adolescents with features of nomophobia and 5.9% with severe nomophobia. Indian researchers have reported 18.5%–39.5%[6,22] of medical students having features of nomophobia. According to a survey, about 53% of British mobile users in Britain suffer from nomophobia.[38] An Indian study[20] found 31.33% of secondary school adolescents to have features of mobile phone dependence. Studies from across the world have confirmed nomophobia to be an emerging and widespread entity.[8,39,40]
In the present study, males were found to have nomophobia more than females [Table 2]. This was similar to finding documented by several studies.[6,11,15,23,33,37,41,42,43,44] In contrast, previous studies have documented that the association between mobile phone use and gender is inconclusive.[11,45,46] In the Udaipur district of Rajasthan, the number of boys enrolled in school is more than girls,[47] and in our study, males outnumbered females. This should be taken into account while interpreting this result. Bianchi and Phillips[11] suggested that mobile phones appeal to and are embraced by both genders equally.
In the present study, nomophobia is positively correlated with depression and anxiety. A survey revealed that 77% of adolescents have reported having anxiety and worries about being without their phone. The psychological factors such as self-negative views, low esteem, younger age, impulsivity, a sense of urgency, and sensation seeking could be related to mobile phone overuse.[11] Depression and dysthymia, alcohol and other substance use disorders, panic disorder, social phobia obsessive–compulsive disorder, eating disorders, and other behavioral addiction disorders (including mobile and/or Internet dependence, gambling, online gaming, compulsive shopping, and sexual behaviors) have been reported to be comorbid with nomophobia.[32] We humbly speculate that it is likely that depressed adolescents may seek social networking platforms or “apps” in order to feel less lonely and good about themselves. On the contrary, it is also likely that symptoms of depressed and anxious adolescents may worsen if they perceive the lives of others through such “apps” to be better than theirs. Adolescents may experience anxiety when they are unable to use a mobile phone and/or the services it offers, when they are unable to access information through smartphones, or when they have to give up the convenience that smartphones provide.[24] Excessive mobile phone use may disrupt adolescents’ academic achievement and contribute to anxiety.[48] Adolescents with anxiety disorders, particularly those with social anxiety disorder, may develop a more severe dependence on mobile phone technologies than those without anxiety disorders.
The present study found a negative correlation between nomophobia and quality of life. It may be reasoned that distress and anxiety associated with not being connected with a mobile phone are negatively related to life satisfaction and subjective well-being (happiness) among nonclinical populations.[49] Excessive mobile phone use by adolescents may be associated with internet addiction[50] which can lower life quality in adolescents. Frequent mobile phone users report health complaints, such as tiredness, stress, headache, anxiety, concentration difficulties, sleep disturbances, and poorer perceived health than less frequent users.[51] Srivastava and Tiwari[52] reported that limited users of cell phones have better mental health and quality of life than unlimited users of cell phones. Excessive time spent on gaming, cyber-sexual activities, online shopping, social networking platforms, etc., are likely to affect interpersonal relationships,[53] coping mechanisms,[54,55] self-esteem,[55] physical activity, and academic and nonacademic achievement of adolescents.
A large sample of adolescent students and assessment using valid and reliable tools are relative merits of the present study. The limitations of the study include the fact that it is a cross-sectional study based on self-report questionnaires administered to students of selected private urban schools. The use of self-report questionnaires to collect information on health aspects has several limitations. It is important to emphasize that the present study concerns subjective symptom-reports and not actual mental disorders or diagnoses. A sleep variable is not taken into consideration in SF-36. The authors have not looked into the individual items and scales of SF-36 and have focused on the total score obtained. There is no consensus validity for nomophobia, as there are no defined diagnostic criteria for mobile phone dependence. However, the Diagnostic and Statistical Manual of Mental Disorders-5 has expanded the criteria for addictive disorders to include certain nonsubstance behavioral addictions such as gambling disorders.[56] Due to the design of the study, it is not possible to conclude whether nomophobia, depression, and anxiety are cause, consequence, or comorbidity. Further studies on nomophobia in nonstudent populations of diverse socioeconomic groups and ethnicities are necessary.
CONCLUSION
The results of the study indicate that nomophobia is an emerging mental health condition. Male adolescents are more frequently represented than females. Nomophobia is significantly associated with depression, anxiety, and poor quality of life. Multicentric studies are needed to better understand this disorder.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
REFERENCES
- 1.King AL, Valença AM, Nardi AE. Nomophobia: The mobile phone in panic disorder with agoraphobia: Reducing phobias or worsening of dependence? Cogn Behav Neurol. 2010;23:52–4. doi: 10.1097/WNN.0b013e3181b7eabc. [DOI] [PubMed] [Google Scholar]
- 2.Kuss DJ, Griffiths MD. Online social networking and addiction – A review of the psychological literature. Int J Environ Res Public Health. 2011;8:3528–52. doi: 10.3390/ijerph8093528. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Chóliz M. Mobile phone addiction: A point of issue. Addiction. 2010;105:373–4. doi: 10.1111/j.1360-0443.2009.02854.x. [DOI] [PubMed] [Google Scholar]
- 4.Potenza MN. Should addictive disorders include non-substance-related conditions? Addiction. 2006;101:142–51. doi: 10.1111/j.1360-0443.2006.01591.x. [DOI] [PubMed] [Google Scholar]
- 5.Griffiths MD. Technological addictions. Clinical Psychol Forum. 1995;76:14–9. [Google Scholar]
- 6.Dixit S, Shukla H, Bhagwat A, Bindal A, Goyal A, Zaidi AK, et al. A study to evaluate mobile phone dependence among students of a medical college and associated hospital of central India. Indian J Community Med. 2010;35:339–41. doi: 10.4103/0970-0218.66878. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Oksman V, Turtiainen J. Mobile communication as social stage meanings of mobile communication in everyday life among teenagers in Finland. N Media Soc. 2004;6:319–39. [Google Scholar]
- 8.Krajewska-Kułak E, Kułak W, Stryzhak A, Szpakow A, Prokopowicz W, Marcinkowski JT. Problematic mobile phone using among the Polish and Belarusian University students, a comparative study. Prog Health Sci. 2012;2:45–50. [Google Scholar]
- 9.Farooqui IA, Pore P, Gothankar J. Nomophobia: an emerging issue in medical institutions. Journal of Mental Health. 2018;27:438–41. doi: 10.1080/09638237.2017.1417564. [DOI] [PubMed] [Google Scholar]
- 10.Toda M, Monden K, Kubo K, Morimoto K. Mobile phone dependence and health-related lifestyle of university students. Soc Behav Pers. 2006;34:1277–84. [Google Scholar]
- 11.Bianchi A, Phillips JG. Psychological predictors of problem mobile phone use. Cyberpsychol Behav. 2005;8:39–51. doi: 10.1089/cpb.2005.8.39. [DOI] [PubMed] [Google Scholar]
- 12.James D, Drennan J. Exploring Addictive Consumption of Mobile Phone Technology. Australian and New Zealand Marketing Academy conference, Perth, Australia. 2005 [Google Scholar]
- 13.Jenaro C, Flores N, Gómez-Vela M, González-Gil F, Caballo C. Problematic internet and cell-phone use: Psychological, behavioral, and health correlates. Addict Res Theory. 2007;15:309–20. [Google Scholar]
- 14.Sánchez-Martínez M, Otero A. Factors associated with cell phone use in adolescents in the community of Madrid (Spain) Cyberpsychol Behav. 2009;12:131–7. doi: 10.1089/cpb.2008.0164. [DOI] [PubMed] [Google Scholar]
- 15.Beranuy M, Oberst U, Carbonell X, Chamarro A. Problematic internet and mobile phone use and clinical symptoms in college students: The role of emotional intelligence. Comput Hum Behav. 2009;25:1182–7. [Google Scholar]
- 16.Billieux J, van der Linden M, d’Acremont M, Ceschi G, Zermatten A. Does impulsivity relate to perceived dependence on and actual use of the mobile phone? Appl Cogn Psychol. 2007;21:527–37. [Google Scholar]
- 17.Ehrenberg A, Juckes S, White KM, Walsh SP. Personality and self-esteem as predictors of young people’s technology use. Cyberpsychol Behav. 2008;11:739–41. doi: 10.1089/cpb.2008.0030. [DOI] [PubMed] [Google Scholar]
- 18.King AL, Valença AM, Silva AC, Baczynski T, Carvalho MR, Nardi AE. Nomophobia: Dependency on virtual environments or social phobia? Comput Hum Behav. 2013;29:140–4. [Google Scholar]
- 19.King AL, Valença AM, Silva AC, Sancassiani F, Machado S, Nardi AE. Nomophobia: Impact of cell phone use interfering with symptoms and emotions of individuals with panic disorder compared with a control group. Clin Pract Epidemiol Ment Health. 2014;10:28. doi: 10.2174/1745017901410010028. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 20.Nikhita CS, Jadhav PR, Ajinkya SA. Prevalence of mobile phone dependence in secondary school adolescents. J Clin Diagn Res. 2015;9:VC06–9. doi: 10.7860/JCDR/2015/14396.6803. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21.Aggarwal M, Grover S, Basu D. Mobile phone use by resident doctors: Tendency to addiction-like behaviour. Ger J Psychiatry. 2012;15:50–5. [Google Scholar]
- 22.Pavithra MB, Madhukumar S. A study on nomophobia-mobile phone dependence among students of a medical College in Bangalore. Natl J Community Med. 2015;6:340–4. [Google Scholar]
- 23.Singh B, Gupta R, Garg R. Mobile phones; A boon or bane for mankind? Behavior of medical students. Int J Innov Res Dev. 2013;2:196–205. [Google Scholar]
- 24.Yildirim C. Exploring the dimensions of nomophobia: Developing and validating a questionnaire using mixed methods research [dissertation] Iowa State University. 2014 [Google Scholar]
- 25.Walsh SP, White KM, Young RM. Over-connected? A qualitative exploration of the relationship between Australian youth and their mobile phones. J Adolesc. 2008;31:77–92. doi: 10.1016/j.adolescence.2007.04.004. [DOI] [PubMed] [Google Scholar]
- 26.Beck AT, Steer RA, Brown GK. Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation; 1996. [Google Scholar]
- 27.Fydrich T, Dowdall D, Chambless DL. Reliability and validity of the beck anxiety inventory. J Anxiety Disord. 1992;6:55. [Google Scholar]
- 28. [Last accessed on 2020 Jun 29]. Available from: https://www.rand.org/health-care/surveys_tools/mos/36-item-short-form.html .
- 29.Basker M, Moses PD, Russell S, Russell PS. The psychometric properties of Beck Depression Inventory for adolescent depression in a primary-care paediatric setting in India. Child Adolesc Psychiatry Ment Health. 2007;1:8. doi: 10.1186/1753-2000-1-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 30.Jörngården A, Wettergen L, von Essen L. Measuring health-related quality of life in adolescents and young adults: Swedish normative data for the SF-36 and the HADS, and the influence of age, gender, and method of administration. Health Qual Life Outcomes. 2006;4:91. doi: 10.1186/1477-7525-4-91. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 31.SPSS Inc. SPSS for Windows, Version 16.0. Chicago: SPSS Inc; 2007. [Google Scholar]
- 32.Lemon J. Can we call behaviours addictive? Clin Psychol. 2002;6:44–9. [Google Scholar]
- 33.Bivin JB, Mathew P, Thulasi PC, Philip J. Nomophobia-Do we really need to worry about? Rev Prog. 2013;1:1–5. [Google Scholar]
- 34.Bragazzi NL, Del Puente G. A proposal for including nomophobia in the new DSM-V. Psychol Res Behav Manag. 2014;7:155–60. doi: 10.2147/PRBM.S41386. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 35.Lopez-Fernandez O, Honrubia-Serrano L, Freixa-Blanxart M, Gibson W. Prevalence of problematic mobile phone use in British adolescents. Cyberpsychol Behav Soc Netw. 2014;17:91–8. doi: 10.1089/cyber.2012.0260. [DOI] [PubMed] [Google Scholar]
- 36.Bhatia MS. Cell phone dependency-a new diagnostic entity. Delhi Psychiatry J. 2008;11:123–4. [Google Scholar]
- 37.Walsh SP, White KM, Cox S, Young RM. Keeping in constant touch: The predictors of young Australians’ mobile phone involvement. Comput Hum Behav. 2011;27:333–42. [Google Scholar]
- 38. [Last accessed on 2020 Jun 29]. Available from: https://www.dailymail.co.uk/news/article-550610/Nomophobia-fear-mobile-phone-contact--plague-24-7-age.html .
- 39.Sahin S, Ozdemir K, Unsal A, Temiz N. Evaluation of mobile phone addiction level and sleep quality in university students. Pak J Med Sci. 2013;29:913–8. doi: 10.12669/pjms.294.3686. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 40.Chóliz M. Mobile-phone addiction in adolescence: The test of mobile phone dependence (TMD) Prog Health Sci. 2012;2:33–44. [Google Scholar]
- 41.Gupta N, Krishnamurthy V, Majhi J, Gupta S. Gadget dependency among medical college students in Delhi. Indian J Community Health. 2013;25:362–6. [Google Scholar]
- 42.Griffiths MD, Hunt N. Dependence on computer games by adolescents. Psychol Rep. 1998;82:475–80. doi: 10.2466/pr0.1998.82.2.475. [DOI] [PubMed] [Google Scholar]
- 43.Morahan-Martin J, Schumacher P. Incidence and correlates of pathological Internet use among college students. Comput Hum Behav. 2000;16:13–29. [Google Scholar]
- 44.Bhise AT, Ghatule AA, Ghatule AP. Study of internet addiction among students wrt gender and education. Indian Journal of Research in Management, Business and Social Sciences. 2014;2:17–21. [Google Scholar]
- 45.Szpakow A, Stryzhak A, Prokopowicz W. Evaluation of threat of mobile phone–addition among Belarusian University students. Prog Health Sci. 2011;1:96–100. [Google Scholar]
- 46.Tasdemir M, Hidiroglu S, Gurun H, Ozer HD, Cicek M, Cetinkaya MZ. The knowledge. Attitude and behaviours of Marmara University Students about the usage of mobile phones. Marmara Med J. 2012;25:18. [Google Scholar]
- 47. [Last accessed on 2020 Jun 29]. Available from: http://www.dise.in/Downloads/Sample%20Checking/5Sample%20checking%202011-12/Sample%20Report%20for%20Rajathan.pdf .
- 48.Lepp A, Barkley JE, Karpinski AC. The relationship between cell phone use, academic performance, anxiety, and satisfaction with life in college students. Comput Hum Behav. 2014;31:343–50. [Google Scholar]
- 49.Asberg KK, Bowers C, Renk K, McKinney C. A structural equation modeling approach to the study of stress and psychological adjustment in emerging adults. Child Psychiatry Hum Dev. 2008;39:481–501. doi: 10.1007/s10578-008-0102-0. [DOI] [PubMed] [Google Scholar]
- 50.Ha JH, Kim SY, Bae SC, Bae S, Kim H, Sim M, et al. Depression and internet addiction in adolescents. Psychopathology. 2007;40:424–30. doi: 10.1159/000107426. [DOI] [PubMed] [Google Scholar]
- 51.Söderqvist F, Carlberg M, Hardell L. Use of wireless telephones and self-reported health symptoms: A population-based study among Swedish adolescents aged 15-19 years. Environ Health. 2008;7:18. doi: 10.1186/1476-069X-7-18. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 52.Srivastava A, Tiwari RP. Effect of excess use of cell phone on adolescent’s mental health and quality of life. Int Multidiscip e-J. 2013;2:1–10. [Google Scholar]
- 53.Kamibeppu K, Sugiura H. Impact of the mobile phone on junior high-school students’ friendships in the Tokyo metropolitan area. Cyberpsychol Behav. 2005;8:121–30. doi: 10.1089/cpb.2005.8.121. [DOI] [PubMed] [Google Scholar]
- 54.Augner C, Hacker GW. Associations between problematic mobile phone use and psychological parameters in young adults. Int J Public Health. 2012;57:437–41. doi: 10.1007/s00038-011-0234-z. [DOI] [PubMed] [Google Scholar]
- 55.Vernon L, Modecki KL, Barber BL. Mobile phones in the bedroom: Trajectories of sleep habits and subsequent adolescent psychosocial development. Child Dev. 2018;89:66–77. doi: 10.1111/cdev.12836. [DOI] [PubMed] [Google Scholar]
- 56.American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®) American Psychiatric Publication; 2013. [Google Scholar]