Mobile Phone Use and Stress, Sleep Disturbances, and Symptoms of Depression among Young Adults - A Prospective Cohort Study

Sara Thomée; Annika Härenstam; Mats Hagberg

Disclosures

BMC Public Health. 2011;11 

In This Article

Background

Mental health problems have been increasing among young people in Sweden and around the world.[1,2] Cultural and social changes in terms of increased materialism and individualism have been discussed in relation to this,[3,4] including the possibility of a decreasing stigma about mental illness, improved screening for mental illness, and increased help-seeking behaviors.[5] Because of the quick development and widespread use of mobile phones, and their vast effect on communication and interactions in work and private life, it is important to study possible negative health effects of the exposure. Extensive focus has been on exposure to electromagnetic fields (EMF). Self-reported symptoms associated with using mobile phones most commonly include headaches, earache, and warmth sensations,[6,7] and sometimes also perceived concentration difficulties and fatigue.[6] However, EMF exposure due to mobile phone use is not currently known to have any major health effects.[8] Another aspect of exposure is ergonomics. Musculoskeletal symptoms due to intensive texting on a mobile phone have been reported,[9] and techniques used for text entering have been studied in connection with developing musculoskeletal symptoms.[10] However, our perspective is predominantly psychosocial.

In a previous study we found prospective associations between high information and communications technology (ICT) use, including high frequency of mobile phone use, and reported mental health symptoms among young adult college and university students,[11] but concluded that the causal mechanisms are unclear. The study was followed by a qualitative interview study with 32 subjects with high computer or mobile phone use, who had reported mental health symptoms at 1-year follow-up. Based on the young adults' own perceptions and ideas of associations, a model of possible paths for associations between ICT use and mental health symptoms was proposed,[12] with pathways to stress, depression, and sleep disorders via the consequences of high quantitative ICT use, negative quality of use, and user problems. Central factors appearing to explain high quantitative use were personal dependency, and demands for achievement and availability originating from domains of work, study, the social network, and the individual's own aspirations. These factors were also perceived as direct sources of stress and mental health symptoms. Consequences of high quantitative mobile phone exposure included mental overload, disturbed sleep, the feeling of never being free, role conflicts, and feelings of guilt due to inability to return all calls and messages. Furthermore, addiction or dependency was an area of concern, as was worry about possible hazards associated with exposure to electromagnetic fields. For several participants in the study, however, a major stressor was to not be available. The study concluded that there are many factors in different domains that should be taken into consideration in epidemiological studies concerning associations between ICT use and mental health symptoms.[12]

Based on the previous studies, we wanted to focus on some aspects of mobile phone exposure other than mere quantity of use. For example, demands on being available or reachable, regardless of time and space, could be argued to be a stressor irrespective of actual frequency of use. Another key determinant may be the extent to which a person actually perceives his or her own accessibility as stressful. Furthermore, accessibility implies the possibility to be disturbed at all hours, even at nighttime. Having one's sleep interrupted repeatedly can have direct effects on recovery and health. In a study among Finnish adolescents, intensive mobile phone use was linked to poor perceived health among girls, both directly and through poor sleep and waking-time tiredness.[13] Another area of concern could be addiction to the mobile phone. Intensive mobile phone use has been associated with dependency on the mobile phone,[14,15] and problematic mobile phone use has been a focus in the literature concerning psychological aspects of mobile phone use, where criteria for substance addiction diagnoses or behavioral addictions[16,17] have been used to define problematic use[18–24] including compulsive short messaging service (SMS) use.[20] In this context, heavy or problem mobile phone use (overuse) has been associated with somatic complaints, anxiety, and insomnia,[21] depression,[21,24] psychological distress,[22] and an unhealthy lifestyle.[25] However, possible positive effects of mobile phone use on mental health can also be hypothesized, for instance the ease of reaching someone to talk to when in need, implying access to social support. Social support buffers negative effects of stress,[26] while low social support is a risk factor associated with mental health symptoms.[27]

We have previously studied ICT use in relation to mental health symptoms among highly selected study groups (college and university students studying medicine and information technology).[11,12] Most investigations we have found on mobile phone use and mental health outcomes have been cross-sectional studies performed among mainly college students (e.g.,[15,19–23]). It is important to examine possible associations between mobile phone use and mental health outcomes also in a more general or heterogeneous population of young adults, using a longitudinal design.

Aims

The overall aim of this study was to investigate whether there are associations between psychosocial aspects of mobile phone use and mental health symptoms in a prospective cohort of young adults. Specific aims were to examine whether the frequency of mobile phone use, but also more qualitative aspects of mobile phone use (demands on availability, perceived stressfulness of accessibility, being awakened at night by the mobile phone, and perceived personal overuse of the mobile phone), are associated with reported stress, symptoms of depression, and sleep disturbances. Furthermore, we wanted to examine whether frequency of mobile phone use is associated with perceived social support.

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