Written by Hyunjoo Shim, Licensed Clinical Psychologist

Since the mass adoption of smartphones with iPhone and Android Apps about a decade ago, I believe that no other device in history has changed and shaped the lives of people across multiple domains (e.g., personal communication, source of entertainment, marketing and promotion of goods and services, creating and sharing contents), regardless of age groups.


Teenagers and college students are particularly notable in their daily reliance on smartphones. If you asked one to stay away from their smartphone for a week, you would be likely be met with a blank stare and: “how could a life without my phone even be possible?”. They wake up in the morning with pre-set alarms on their phones, scroll through Instagram and answer Snapchats, listen to music even in shower, watch Netflix in their free time, KakaoTalk friends, play games, order food, and shop around – all on their smartphones. Almost all the functionalities of camera, TV, MP3, phone, radio, computer, and instant messaging are all embedded in a single device with incredible portability and ubiquitous connectivity to the Internet.

The explosive and exponential growth of smartphone usage at the personal and societal levels is often deemed inevitable, frequently viewed as a double-edged sword. It is estimated that the 61.2 percent of global mobile phone population has an access to the internet from their mobile phone in 2018. When in an adaptive use, a smartphone can be an unbeatable tool to organize daily routines, maintain physically distanced connections, keep occupied and entertained, and play an active participant of a desired group.


Still, due to its versatility, concerns related to the negative consequences of excessive smartphone use have been strongly voiced over time. To name a few of smartphone-related to phenomenon, phantom vibration (ringing) syndrome refers to the perception error of an individual imagining that a silent mobile phone is vibrating and/or ringing. While No Mobile Phone Phobia (NOMO) and Fear of Missing Out (FOMO) can cause emotional disturbances, Smombie (smartphone + zombie) syndrome, which occurs when a person completely absorbed in his/her smartphone while walking around, can cause dangerous physical behavior. In addition to the belief distortion, emotional struggle, and physical hazards, well-known bodily conditions such as forward-neck syndrome are possible unhealthy outcomes of excessive smartphone usage.


What this means for the psychology profession


Smartphone addiction is not currently diagnosable in clinical settings, as the current Diagnostic and Statistical Manual 5 (DSM-5) does not provide the necessary criteria to identify “behaviors” as addiction. Until the 1990s, the DSM classification system recognized substance use related addictions including the dependence and abuse of alcohol and drugs. Since the 2000s, researchers and clinicians have brought its attention to the necessity to include and differentiate behavioral addictions including “gambling, gaming, and internet use”. This new class of behavioral addiction was proposed to reflect the widespread excessive behaviors that impact individual lives and those surrounding the individual. However, only “Internet gaming addiction” has been included when, in 2014, DSM-5 rolled out an appendix as a to-be-further-researched condition.


When it comes to clinically diagnosed addictions, there are three major criteria to be considered: withdrawal, tolerance, and impairment in functioning. Withdrawal is a group of symptoms, such as physical aching and emotional anxiety, that is experienced when substance use is decreased or eliminated. Tolerance refers to developing a heightened dosage requirement of intake/use of a given substances to achieve the same initial level of highness or pleasure. Functional impairment includes relationship strain, damaged academic or work performances, and financial issues associated with substance dependence or abuse.


The three criteria, in addition to substance addiction, can also be applied to behavioral addiction as well. Although the existence and classification of smartphone addiction remains in debate among researchers and health providers, smartphone addiction has similar conceptual overlap with internet addiction. The aforementioned NOMO or FOMO reflect withdrawal symptoms, while becoming as Smombie is an example of excessive and compulsive use that impacts daily functioning along with safety concerns.

Mark Griffiths, a distinguished professor of behavioral addiction and director of the international gaming research unit in the psychology department at Nottingham Trent University in UK, has further identified six nuanced aspects of behavioral addiction: salience, mood modification, tolerance, withdrawal, conflict, and relapse. When these concepts are applied to smartphone use, if an individual finds that the smartphone is the only source of entertainment and enjoyment (salience) in daily lives, depends on smartphone to comfort and soothe him/herself (mood modification), ends up using smartphone more than intended (tolerance), feels irritated and snappy when not in use or disruption (withdrawal), encounters with frequent arguments and tension with family (conflict), tries not to use the smartphone in vain (relapse), then the individual is likely to become or stay addicted to a smartphone.


What sets smartphone addiction apart


Compared to the more well-known internet addiction, recent research suggests that the social extroversion and introversion scale on the Minnesota Multiphasic Personality Index 2 is found to be a discriminant factor between the two addictions. Respondents in the high internet addiction group reported significantly more social discomfort and introversion, compared to those in the high smartphone addiction group. In other research, a group of users addicted to smartphones reports more social and friendly attitudes, as well as stronger motivation to share positive interpersonal experiences compared to a group of internet addiction users. Given that smartphone use tends to be driven by expression of self, others’ approval, and fear of missing out on desired experiential opportunities, interpersonal and social factor need to be considered in order to differentiate assessment outcomes and to further inform treatment focus and approach.


Methodically rigorous research is in definite need to clearly guide diagnosis and deliver effective treatment for smartphone addiction in the absence of clear diagnostic criteria for it in DSM-5. In the meantime, health providers are likely to gain better clinical understanding through research outcomes and insight into relatively new, but salient, phenomenon surrounding smartphone use and its issues.


For smartphone users, it is very important to stay mindful of what drives them to use smartphones, how much time is spent on using their phones, whether or not they are using them for their benefits and what they can do to keep themselves busy or entertained or connected w/o smartphones.