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Chapter-I

INTRODUCTION

“Humanity is acquiring all the right technology for wrong reasons”- R Buckminster
Fuller.

Although the developments in technology have made our lives and daily activities
easier, it is believed that problematic and excessive use of technology could have some
negative effects on people. One of these negative effects is the prevalence of
nomophobia, which is considered as a new phobia. Nomophobic tendencies can change
individuals’ daily habits. Negative emotions due to nomophobic tendencies like fear and
social anxiety especially in young people is thought to affect their school lives and
academic achievements (Gezgin & Cakır, 2016). Given the diverse range of functions
afforded by this pocket sized gadget – from communication to navigation and
entertainment – the popularity of the smartphone seems inevitable. (Montag, Duke, &
Markowetz, 2016; Montag, Reuter, & Markowetz, 2015). As cell phones offer a
technologically advanced method of social interaction, the risk of becoming obsessed can
hinder happiness. Most impressively, smartphone introduced the ‘World of Apps’ where
applications can be got for almost anything and everything. In this way gradually
smartphone with their all solutions at palm applications and technologies have crept into
human world. They have made users so helplessly dependent that one may be at a loss if
smartphone vanished (Kanmani, Bhavani, & Maragatham, 2017) and smartphones can
be addictive (Chiu, 2014; Lee, Chang, Lin, & Cheng, 2014; Salehan & Negahban, 2013).
Dependency on smartphone is making individuals socially isolated and anxious. Social
anxiety is a major problem for children and adolescents given that it may be difficult for
socially anxious youth to initiate social interactions, become accepted within the larger
peer group, and develop close intimate friendships (Bowles, 2016). So, the aim of the
current study is to examine the relationship and prevalence of smartphone addiction,
nomophobia and social anxiety in the college and university students (adolescents).
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Smartphone Addiction

The cellphone has become an integral part of the lives of most people during
recent years. Cellphone addiction is defined as a habitual drive to continue to use one’s
cellphone repeatedly despite any negative impact on one’s well-being. The
appropriateness of a behavior can be argued as good or bad. However, one problem with
an addiction is a loss of self-control, as people feel compelled to perform a behavior even
to their own detriment (Roberts, Yaya, & Manolis, 2014).

Mobile phone addiction is one of the forms of compulsive use of “a mobile

phone” by adolescents globally that similar to internet addiction, problematic use of them
is on the increase and has caused serious problems in many areas of routine life. (Davey
& Davey, 2014). Several symptoms may indicate that a person has cellphone addiction.
Although cell phone addiction is not yet listed in the Diagnostic and Statistical Manual of
Mental Disorders, 5th Edition (DSM-5), research has compared it to gambling addiction,
which has clearer diagnostic criteria and is included in the DSM-5. Symptoms such as
preoccupation with the device, excessive use with loss of control, use in socially
inappropriate/dangerous situations, symptoms such as feelings of anger, tension,
depression when the phone/network inaccessible, ringer anxiety, constant worry that
battery will drain, signs of craving, need for new better phone, more software or more
hours of use, poor achievements and social isolation in one person may be related to
her/his addiction to mobile phone (Nikhita, Jadhav, & Ajinkya, 2015).

Another sign of potential cellphone addiction is the compulsive behavior of a

person constantly checking their phone for texts and believing he or she must respond
immediately to any messages they receive (Archer, 2013). This is often accompanied
with the inability to pay attention to other people as the person is reading and responding
to the text and posts on social media or text messaging (Archer, 2013). This inability to
concentrate can have negative consequences academically for students as it makes it
difficult to follow directions and complete assignments. Students are one group that is at
high risk of internet and cell phone addiction. Such cell phone addiction is affecting all
aspect of student’s life (Hasandost, 2016).
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In Thailand, one survey claims that 96% of Thais practice “phubbing” or looking
at their cellphone instead of paying attention to the people around them (The Nation,
2013). However, in the same survey the results indicated that over 80% of respondents do
not find the behavior of phubbing acceptable. Inattention through phubbing is yet another
symptom of cellphone addiction with the rates of this particular behavior being high in
Thailand.

Phantom cellphone vibration signal is another symptom of cellphone addiction

(Tanis, Beukeboom, Hartmann, & Vermeulen, 2015). Phantom cellphone vibration is a
person believing their cellphone vibrated when it did not (Thibodeau, 2012). Around 50%
of cellphone users have reported experiencing the phenomenon of phantom cellphone
vibration at least once a week (Tanis et al., 2015). The constant sense that one’s phone is
vibrating can make it difficult to concentrate on other matters such as academics.

Loss of sleep is also a symptom of cellphone addiction (Sahin, Ozdemir, Unsal, &
Temiz, 2013). This loss of sleep is actually felt more by college sophomores and people
who use their cellphone more than 5 hours per day (Sahin et al., 2013). McAllister (2011)
found that 75% of university students sleep next to their phones. Constant access to a
cellphone makes it tempting to use it at times when other activities should be taking
place, such as sleeping. Combining a loss of sleep from cellphone addiction with the
rigors of academic life could lead to a stressful situation for many students.

Another symptom, which pertains especially to university students, is poor

performance in school (Archer, 2013). Roberts et al. (2014) found that addiction to one’s
cellphone can negatively influence academic performance as students’ concentration in
class declines because of cellphone use and disrupts their studies outside of class. Lepp,
Barkley and Karpinski (2014) found a negative relationship between cellphone use and
GPA. However, it is important to note that academic performance and academic stress
are different in constructs with stress normally influencing performance (Sanders, 2013).

Recent studies on smart-phone use found positive correlations between certain

demographics and smart-phone use. These studies found that participants who were
women, African-American, Latino, or in a middle to high socioeconomic status were the
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most likely to use smart-phones, between seven and nine hours (Junco, Merson, & Salter,
2010; Robert, Yaya, & Manolis, 2014). In the world today, there are approximately 6
billion cellphone subscriptions, which represent about 86% of the world’s population
(Associated Press, 2012). In addition to use of mobile phone for communication, people
used cell phone for many features such as games, access to the internet and social
networks, messaging, videos, multimedia, calculator, alarm clock, and navigation
(Demirci, Akgonul, & Akpinar, 2015; Tavakolizadeh, Atarodi, Ahmadpour, &
Pourgheisar, 2014).

Virtually all the studies indicate that females have higher levels of dependence
and problematic use than males (Beranuy, Chamarro, Graner, & Carbonell, 2009; Jenaro,
Flores, Gomez-Vela, Gonzalez-Gil, & Caballo, 2007; Martinotti, Villella, Di Thiene, Di
Nicola, Bria, & Conte, 2011; Sanchez Martinez, & Otero, 2009).

Prevalence of smartphone addiction. Considering the world of developing

information and communication technologies, mobile phone use in our daily lives has a
substantial degree of importance. Mobile phones, used intensively by every age group,
bring about lots of difficulties together with the facilities they already offer (Carbonelli,
Guardiola, Beranuy, & Belles, 2009). In a previous study it was reported that the use of
information and connection technology (ICT-Information and Communications
Technology) and increase in the frequency of mobile phone use cause mental health
problems among university students. (Thomee, Harenstam, & Hagberg, 2011). Excessive
and problematic mobile phone use causes dependence (Ahmed & Qazi, 2011; Walsh,
White, & Young, 2008).

In various studies (e.g. Dixit, Shukla, Bhagwat, Bindal, Goyal, & Zaidi, 2010;
Yen, Tang, Yen, Lin, Haung, Liu, & Ko, 2009; Sanchez, Martinez, & Otero, 2009), it has
been reported that dependence on mobile phones is between 18.5% and 48.9%.
Researchers think that problematic mobile phone use is worrying in terms of
psychological and behavioral aspects (Dixit et al., 2010). As smart phone addiction is
increasing day by day in our country also so it is important to address this in our culture.
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Among university students in the United States, about 99.8% own a cellphone
(Ziegler, 2010). In another survey, 51% of university students stated that they could not
imagine living without their cellphone (Saad, 2015). Such dependency indicates
symptoms of addiction. Furthermore, it has been found that 60% of university students
admit that they are addicted to their cellphones (McAllister, 2011).

There is also evidence that university students spend the majority of the day on
their cellphones. It was found in a study that college students use their cellphones on
average 8.75 hours a day. They found that men use their phones for 7.5 hours a day on
average and women use their phones for about 10 hours a day. Both men and women use
their cellphone for a variety of activities from phone calls to browsing the Internet
(Roberts et al., 2014).

Mobile phone overuse is an addiction noticed among certain mobile phone users.
In India, over use is started at 39-44% of young age group (Davey et al., 2014). The
prevalence ranges from 0 to 38%, with self-direction of mobile phone addiction outstrip
the prevalence estimated in the previous studies (Pedrero Perez, Rodriguez Monje, &
Ruiz Sanchez De Leon, 2012).

As use of mobile phones has increased exponentially in the last decade

(Aggarwal, Grover, & Basu, 2012). These devices have become an essential part of our
lives, due to their many functions, such as internet access, social networks, email,
messaging, calling, playing games and online shopping (Cho & Lee, 2016; McBride,
2015; Gill, Kamath, & Gill, 2012).

Nevertheless, smartphones have been designated as potentially addictive and

harmful to individuals’ professional and family life. The users of smartphones have a
growing need to increase the amount of time on their phones in order to feel satisfied and
they also develop a habit of compulsive checking (Oulasvirta, Rattenbury, Ma, & Raita,
2012 ), which can have negative effects on daily life (Griffiths, 2005). This addiction to
mobile phones has given rise to the term nomophobia, defined as an uncontrollable fear
of leaving home without a mobile phone. It might be regarded as one of the side effects
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related to overuse of smartphone (Bragazzi, & Puente, 2014; King, Valenca, Silva,
Baczynski, Carvalho, & Nardi, 2013).

Nomophobia

Nomophobia is an emerging human behavior phenomenon stemming from

widespread mobile phone use (Oulasvirta, Rattenbury, Ma, & Raita, 2012; Arpaci, 2017),
which causes symptoms such as: anxiety, emotional instability, aggressiveness and
difficulty concentrating (King, Valenc, Silva, Sancassiani, Machado, & Nardi, 2014). A
typical Nomophobe can be identified by some characteristics such as never turning off
the phone, obsessively checking missed texts and calls, bringing the phone everywhere,
using phones at inappropriate times and missing opportunities for face-to-face interaction
while preferring over the phone contact. In some severe cases, people may also face
physical side effects such as panic attacks, shortness of breath, trembling, sweating,
accelerated heart rate, pain in the hand joints, neck and back pain, etc. when their phone
dies or is otherwise unusable (Kanmani, Bhavani, Maragatham, 2017).

Nomophobia (no mobile phone phobia) -The fear/anxiety of being away from
mobile phone contact- is considered a disorder of the contemporary digital and virtual
society that refers to discomfort, anxiety, nervousness or anguish caused by being out of
contact with a mobile phone. The term was coined during a 2010 study by the UK Post
Office who commissioned YouGov, a UK-based research organization that sampled 2163
people to look at anxieties suffered by mobile phone users. The study found that nearly
53% of mobile phone users in Britain tend to be anxious when they "lose their mobile
phone, run out of battery or credit, or have no network coverage" (Kanmani et al., 2017).

Although nomophobia does not appear in the current DSM-V (Diagnostic &
Statistical Manual of Mental Disorders, 5th Ed), it is proposed as a "specific phobia",
based on definitions given in the DSM-IV (Bragazzi & Puenete, 2014). For this reason,
nomophobia is considered as a modern age phobia that is introduced to our lives as a
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byproduct of the interaction between people and mobile information and communication
technologies, especially smartphones (Yildirim & Correia, 2015, p. 130). The increased
use of mobile internet results in increased levels of nomophobia (Gezgin, Cakir, &
Yildirim, 2017).

In a previous study independent sample t-test was conducted to examine whether

or not nomophobia levels of high school students differ in terms of gender. The
independent sample t-test analysis indicates that there was a significant difference
between female and male students regarding to their nomophobia levels. The findings
indicated that female students have more tendency to show nomophobic behaviors
compared to the male students (Gezgin, Cakir, & Yildirim, 2018).

Prevalence of nomophobia. Many surveys and studies performed in different

countries and cultural background from the Poland (Krajewska-Kułak, Kułak, Stryzhak,
Szpakow, Prokopowicz, & Marcinkowski, 2012) Pakistan (Sahin, Ozdemir, Unsal, &
Temiz, 2013) and Spain (Choliz, 2012) have shown that nomophobia is universally
widespread and present. In a cross-sectional study conducted among 200 medical
students aged between 17 and 28 years in Indore, India, it was found that 18.5% had
nomophobic behaviors. 73% of the students stated that they keep their phones near them
while sleeping, and 20% said they feel under pressure and lose concentration when they
do not have their phones with them or when it runs out of battery charge (Dixit Shukla,
Bhagwat, Bindal, Goyal, Zaidi, & Shrivastava, 2010).

A study conducted in Bangalore on students of a medical college showed that

about 23% students felt they lose concentration and become stressed when they do not
have their mobile around, 79(39.5%) students were nomopobic in this study and another
27% were at risk of developing nomophobia (Pavithra, Suwarna, Mahadeva Murthy,
2015).

Although nomophobia is not included in the field of clinical psychology, studies

about nomophobia are being conducted and its worldwide prevalence among individuals.
According to the findings of a study conducted among people in professional life
(SecurEnvoy, 2012), it was reported that the number of cellphone users exhibiting
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nomophobic behaviors had increased over the past four years. Accordingly, 66% of
smartphone and cellphone users stated that they felt anxious because of the idea of losing
their phones and expressed their fear about it (SecurEnvoy, 2012).

Another study conducted in India examines the prevalence of nomophobia and

smartphone usage among third-year medical students (Sharma, Sharma, Sharma, &
Wavare, 2015). Their study was conducted with the participation of 130 students aged
between 22 and 24 years. 73% of the students were found to be nomophobic and 83% of
them reported having panic attacks when they cannot find their mobile devices. Panic
disorder indicates frequent and constant anxiety attacks. In a study conducted by King et
al., (2014) in Brazil, the symptoms and mood changes of patients with panic disorder due
to mobile phone usage were examined. A total of 120 people participated in this
experimental study and it was found that both the experimental group (with panic
disorder) and the control group (reported as healthy) showed dependence on mobile
phones. However, not being able to use a mobile device was found to cause more
extensive mood changes and physical and psychological symptoms in patients with panic
disorder.

In another study conducted with the participation of 163 university students, the
mobile phones of nearly half the participants were taken away, whilst the remainder was
asked to turn off their mobile phones and put them away. An anxiety scale, which was
applied during time without phones, showed that anxiety levels of participants increased
as time passed (Cheever, Rosen, Carrier, & Chavez, 2014). In a study conducted on
university students in France, it was reported that nearly one-third of students suffer from
nomophobia (Tavolacci et al., 2015).

When nomophobia studies in Turkey are examined, it is found that nomophobia

levels of students are above the average, based on the findings of a study conducted with
the participation of 433 students from a state university (Adnan & Gezgin, 2016). In
another study, the prevalence of nomophobia among 838 teacher candidates from
different departments was found to be high (Yildirim, Sumuer, Adnan, & Yildirim,
2016). Similarly, in a study conducted on adolescents from high schools in Edirne and
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Izmir, it was revealed that the prevalence of nomophobia is above average (Gezgin &
Cakir, 2016).

For many people the smart phone has become an extension of their ear, from the
moment they wake up until the second they fall asleep. The increasing utilization of new
technological devices and virtual communication involving personal computers, tablets
and mobile phones (smart phones) are causing changes in individuals’ behaviour and
daily habits. Besides providing various advantages these new technologies, can lead to
many type of social problems (like social isolation and social anxiety) and
economic/financial problems like larger debts taken to buy or use smart phones (Beranuy,
Oberst, Carbonell, & Chamarro, 2009).

Social Anxiety

Adolescence, the period of life between approximately 12 and 18 years of age

(Lerner & Steinberg, 2013), is a critical phase for the development of anxiety symptoms,
and social anxiety symptoms in particular. Social anxiety involves a marked and
persistent fear of one or more social or performance situations in which the person is
exposed to unfamiliar people or to possible scrutiny by others (American Psychiatric
Association, 2013).

Social anxiety is a pervasive societal problem. Individuals with this condition

report significant distress when interacting in social situations or performing in public.
Several investigators have suggested this condition is characterized by heightened
physiological arousal when in social situations, a fear of negative evaluation by others, a
high likelihood of negative expectations regarding the ability to interact with others and,
in some cases, deliberate avoidance of the threatening situations (Schlenker & Leary,
1982; Watson & Friend, 1969; Zimbardo, 1977).

Social anxiety only happens when one believes that perception of other people
about that person is different from their perception about themselves (Loudin, Loukas &
Robinson, 2003). Inderbitzen, Walters and Bukowski (1997) identified that social anxiety
is a combination of three factors: the experience of distress, the active avoidance of social
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situations and the third one is fear of receiving negative evaluations from others in social
situations. There are many negative effects of social anxiety on individuals. It has also
been suggested that socially anxious individuals may abuse alcohol and/or other
substances to alleviate their subjective distress (DSM-III, 1980; Pilkonis, Feldman, &
Himmelhoch, 1981).

Women and men are equally likely to seek treatment for social anxiety disorder,
but community surveys indicate that women are somewhat more likely to have the
condition (Kessler, Stein, & Berglund 1998). Turk and colleagues reported that in a
clinical sample women feared more social situations and scored higher on a range of
social anxiety measures. It therefore seems that although women are more likely to
experience social anxiety, men may be more likely to seek treatment and to do so with
less severe symptoms (Turk, Heimberg, Orsillo, Holt, Gitow & Street, 1998)

Furthermore, many studies suggest higher levels of social anxiety symptoms in

adolescent girls compared with boys, which has been attributed, for example, to girls
showing higher vigilance toward potential threat than boys and girls experiencing higher
levels of parental overprotection compared with boys (McLean & Anderson, 2009).

Prevalence of social anxiety. The condition of social anxiety significantly affect

the social functioning as well as vocational performance. Estimates of the prevalence of
social anxiety suggest that between 20-41% of the population experience some degree of
performance anxiety or discomfort in social situations. Many of these individuals
experience discomfort to the extent that they avoid social interactions (Curran, 1977;
Zimbardo, 1977).

There are no UK epidemiological surveys that specifically report data on social

anxiety disorder in adults; however, the prevalence of social anxiety disorder has been
included in large general population surveys in other western European countries, the US
and Australia. Prevalence estimates vary, with much of the variability probably being due
to differences in the instruments used to ascertain diagnosis. However, it is clear that
social anxiety disorder is one of the most common of all the anxiety disorders. Lifetime
prevalence rates of up to 12% have been reported (Kessler et al., 1998) compared with
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lifetime prevalence estimates for other anxiety disorders of 6% for generalized anxiety
disorder, 5% for panic disorder, 7% for post-traumatic stress disorder (PTSD) and 2% for
obsessive-compulsive disorder (OCD). Twelve-month prevalence rates as high as 7%
have been reported for social anxiety disorder (Kessler et al., 1998)

Using strict criteria and face-to-face interviews in the US, the lifetime and yearly
prevalence figures are halved to 5% and 3%, respectively (Grant, Stinson, Hasin,
Dawson, Chou, Ruan & Huang, 2005). Data from the National Comorbidity Survey
reveals that social anxiety disorder is the third most common psychiatric condition after
major depression and alcohol dependence (Kessler et al., 1998)

Population rates of social anxiety disorder in children and young people have
been investigated in several countries. As in adult studies, a range of methods have been
used for diagnosis, which probably explains the wide variability in prevalence estimates.
A large New Zealand study reported that 11.1% of 18-year-olds met criteria for social
anxiety disorder (Feehan, McGee, Raja, & Williams, 1994). However, a large, British
epidemiological survey reported that just 0.32% of 5- to 15-year-olds had the disorder
(Ford, Goodman, & Meltzer, 2003)

Relationship of Nomophobia with Smartphone Addiction and Social anxiety

Nomophobia and smartphone addiction share many qualities, but the primary trait
each disorder shares is that the smartphone is a source of relief and comfort (Harkin,
2003). The key reason for this is that smartphones have become central in communication
and are perceived necessary to own in order to stay in touch with others. This gives the
user the option to use the phone compulsively to the point where it can be defined as
behavioral addiction (Tran & Dewey, 2016).

Both nomophobia and smartphone addiction have many comorbid disorders, two
or more disorders within an individual, such as: anxiety and panic disorder, other forms
of phobia (social phobia/social anxiety) alcohol and drug addiction, as well as other
behavioral addiction disorders (including mobile and/or internet dependence, gambling,
online gaming, compulsive shopping, and sexual behaviors) (Bragazzi & Puente, 2014;
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Clayton, Leshner, & Almond, 2015). Much of the literature on nomophobia states that the
DSM-5 social phobia disorder is the most likely comorbid disorder with nomophobia
(Bragazzi & Puente, 2014; King et al., 2013).

A case study on an individual who suffered from extreme social phobia disorder
found that he used his smartphone and personal computer as a means for relieving his
symptoms (King, Valenca, Silva, Baczynski, Carvalho, & Nardi, 2013). It was proposed
that this individual suffered from nomophobia and had comorbid disorders of social
phobia and obsessive-compulsive disorder (King et al., 2013).

Relationship between Smartphone Addiction and Social Anxiety

Smartphones are user friendly and attractive for users, but they can be detrimental
to the user’s health if they are used in a problematic or an addictive manner. An
epidemiological study revealed that people who use mobile phones excessively were
more likely to experience health problems (e.g. headaches, fatigue, impaired
concentration, insomnia, anxiety and hearing problems) (Bianchi &Phillips, 2005).

Kim’s study in South Korea found that smartphone addiction has genuine
consequences which affected student success (Kim, 2013). Sufferers were unable to do
school work, found that interpersonal relationships suffered and felt anxiety and
loneliness without their smartphones. In research on undergraduate students in the US
Emanuel found that one-fifth of respondents were classed as totally dependent on their
smartphones and about one-half were overly dependent (Emanuel et al., 2015). Their
literature review also concluded that college age students are the group most likely to be
nomophobic. Evidence from a study in Saudi Arabia supports this view and the negative
consequences of smartphone addiction (Alosaimi et al., 2016).

Individuals with psychosocial problems such as social phobia or feelings of

loneliness might be vulnerable to excessive use of cyber technological devices, such as
smartphones. They would prefer other methods of communication, particularly via
mobile technological devices, rather than face-to-face communication because this type
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of communication can cause less anxiety (Darcin, Kose, Noyan, Nurmedov, Yilmaz &
Dilbaz, 2016).

A previous study conducted to analyze loneliness (distress in social situations) of

university students according to mobile phone addiction, daily phone use time and gender
showed that loneliness was significantly associated with problematic mobile phone use
Tanha, Pamuk, & Donder, 2013).

Nevertheless, Casey (2012) stated that smartphone addiction may cause someone
to feel lonely. This is because loneliness is an undesirable feeling that derives from
inconsistency between wished and accomplished levels of social connection (Perlman &
Peplau, 1981). Smartphone addiction might influences the way people communicate and
causing social stress (Perlman et al., 1981). People who tend to have higher level of
nervous and afraid to see people face to face as well as present into social directly mostly
cause with their high levels of social stress (Bolle, 2014). However, people in this
modern century who addicted to smartphone because of other functions, applications and
characteristics on the smartphone such as reading books online, surfing on Facebook,
Twitter, Instagram and playing online games. They tend to overindulge and focus in their
smartphones until ignore who they are with in person (Casey, 2012).

Rationale

The 21st century is regarded as the century of information and communication

technologies (Hussain, 2005) with potential to enhance capacities and capabilities
(Hussain, Cakir, Ozdemir, & Tahirkheli, 2017) and emerging application (apps), tools
and devices. Amongst other mobile devices particularly the mobile phones have
enhanced connectivity interactions of the users. Apparently, one can observe mobile
phones particularly, the smart phones to be popular connectivity devices among the youth
predominantly, among university students (Hussain & Adeeb, 2009).

According to Netburn (2012) advancements in information and communication

technologies have made communicating easier, but at the same time created new
problems. Excessive use of mobile phones including smart phones has created problems
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and challenges for university students and concerns of their parents. The most pressing
ones consist of physical or health, psychological, and social problems/ social phobia
(Hussain, 2005; Hussain et al., 2017). Nomophobia is also one of the psychological
problems and it is demonstrated by addictive use smart/ mobile phones by university
students and other users as well (Yildirim, 2014). As nomophobia is considered the
phobia of the 21st century because smart phones have become today an important part of
our techno-culture especially among the younger population, whose primary need is to
socialize, join in and to be liked. Research shows that nomophobia is on the rise across
the globe and more and more people fear of being without or losing their mobile device
(Bivin, Mathew, Thulasi, & Philip, 2013).

Many researches were conducted on nomophobia in the past e.g. a study

conducted in the UK in 2008 stated that 66% of the teenagers and younger population are
troubled with the idea of losing their mobile phones (Pavithra et al., 2015). Another study
conducted in the past identified that, millions of people suffer from nomophobia around
the globe. The most affected are from 18-24 years of age (Kanmani et al., 2017).
Nomophobia is common nowadays. The findings from the studies conducted in different
cultures (e.g. Choliz, 2012; King et al., 2013; Oksman & Turtiainen, 2004) reveal how
common and up-to-date the nomophobia is worldwide despite the fact that it is not
literally present in the literature (Gezgin, Hamutoglu, Sezen-Gultekin, & Ayas, 2018).
By considering the increased prevalence of nomophobia and its harmful effects in the
previous researches it is important to study nomophobia among the sample of university
students.

Literature survey showed limited data regarding nomophobia although the

disorder has been identified among smartphone users (Dixit, Shukla, Bhagwat, Bindal,
Goyal, & Zaidi, 2010). Although nomophobia has received a great deal of attention by
media, yet research into nomophobia has been scant. A review of literature includes the
case study examining the relationship between nomophobia and panic disorder (King,
Valenca, & Nardi, 2010), and another case by King et al., (2013) examining nomophobia
as a manifest behavior. Taking this background into account, we conducted this study to
 15

explore the prevalence and relationship of smartphone addiction, nomophobia and social
anxiety among University and College students.

New technologies have brought new forms of addiction with them. Traditional
addictions to alcohol, drugs or gambling have now been joined by addictions to
videogames, the internet and even mobile phones. Smartphone addiction, is one of the
newest forms of digital addiction and as such has been less researched than other forms,
such internet addiction, for example researchers in South Korea (Kim, 2013; Kwon et al.,
2013) have found that levels of smartphone addiction are even higher than internet
addiction (Davie & Hilber, 2017). As per researcher’s knowledge there is scarcity of
literature on the modern form of digital addiction (smartphone addiction) so the aim of
current study is to inquire the smartphone addiction along with nomophobia and social
anxiety.

The world over, it is the younger generation, especially students, that tend to be
more adaptive to technological devices like smartphones when compared to their elders
(Arif & Aslam, 2014). In a study conducted on teenagers in Australia, it is stated that
smartphone usage is an important part of their life and it is becoming more popular day
by day (Walsh, White, & Young, 2008). As more and more teenagers are becoming
victim of nomophobia and smartphone addiction so this motivated me to conduct the
research on University and College adolescents (teenagers) and study the prevailing
issues (smartphone addiction, nomophobia and social anxiety).

There are many adverse effects of smartphone addiction and nomophobia in

social, psychological, occupational, and academic life of an individual. It was also
reported in a study some risks and side (negative) effects which were associated with the
use of smartphones and internet. These include social effects (dependence and
distractions), academic (low academic achievement, interruption in educational
activities), psychological (personality disorder, dissatisfaction & loneliness, social
anxiety, depression, aggression, attention deficit-disorder and empathy disorder) and
physical side effects (hypertension, obesity etc.)(Ozdemir, Cakir, & Hussain, 2018).
Frequent and extensive use of smartphones has also brought about numerous
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disadvantages to individuals’ lives, and especially to teenagers. One of the disorders

caused by the use of smartphones is nomophobia, which is defined as an intense and
irrational fear of being out of mobile phone contact (Bragazzi et al., 2014). It is also
believed that the recent increase in popularity of smartphones has increased the
prevalence of nomophobia amongst teenagers (Attamimi, 2011). Due to harmful effects
of smartphone addiction it was necessary to explore its prevalence among the teenagers.

Everyone in this modern world is becoming a victim of nomophobia.

Smartphones are not just becoming a part of our daily lives - but a part of each and every
one of us. The presence of this handy device that holds the world just a touch away has
been greatly significant and unavoidable in our standard of living. It is surprising to note
that an average person checks their phone 110 times per day, even without their
knowledge or any reason. So, nomophobia is the emerging issue of the modern era
(Kanmani et al., 2017).

The prevalence of nomophobia was reported by many researchers in the past e.g.
King, Valenca and Nardi (2010) studied the prevalence of nomophobia and regarded it as
a disorder of the 21st century caused by new technologies [emerging information and
communication technologies and their apps] and devices. The study conducted by
Gezgin, and Cakir (2016) revealed nomophobic behaviors of high school students to be
above average. According to Krajewska-Kulak (2012) almost 1/5 of students from Poland
and 1/10 from Belarus had the symptoms of mobile phone-addiction –nomophobia. A
study in Australia on usage of mobile phones concluded that students’ addiction rate of
mobile phones was recorded between 1.5 to 5 hours on daily basis (James and Drennan
2005).As per my knowledge there are many studies on the prevalence of nomophobia but
the uniqueness of my study is that it is a relationship study of nomphobia with
smartphone addiction and social anxiety along with the prevalence.

Many researches are also conducted on nomophobia in Pakistan e.g. a study a

conducted on mobile phones addiction among university students in twin cities of
Pakistan (Shahzad, Shahzad, Ahmed, Hussain, & Riaz, 2015). Another research was
conducted to measure the enormity of nomophobia among youth in Pakistan (Nawaz,
 17

Sultana, Amjad, & Shaheen, 2017). A comparative study of Pakistani and Turkish
undergraduates was conducted on the prevalence of nomophobia.

The revolution of information and communication technologies has not only

changed the way we communicate and access information, but it has also resulted in the
emergence of new phobias and mental disorders (nomophobia and social anxiety)
(Bragazzi et al., 2014). However, there are few studies done to examine the relationship
between smartphone usage behaviors and social anxiety or loneliness (Gao, Ang,
Tingshao, Xiaoqian, & Xingyun, 2016). In previous researches there is no exact data on
the prevalence and relationship of smartphone addiction, nomophobia and social anxiety
among University and College students. Therefore aim of the current study is to
determine the prevalence and relationship of smartphone addiction, nomophobia and
social anxiety.

Conceptual Model of the Study

Gender
 18

Figure 1. The figure shows conceptual framework of the relationship of smartphone

addiction, nomophobia, and social anxiety.

Chapter-II

METHOD

Objectives

In proposed study following objectives are formulated:

1. To investigate the relationship in smartphone addiction, nomophobia and social

anxiety.
2. To explore the gender differences on study variables.

Hypotheses

In the proposed study, following hypotheses have been formulated:

1. Smartphone addiction will positively predict nomophobia.

2. Smartphone addiction will positively predict social anxiety.
3. Nomophobia will positively predict social anxiety.
4. Female students will have more smartphone addiction than male.
5. Female students will have more nomophobia than male.
6. Female students will have more social anxiety than male.
Research Design
 19

The aim of the present study is to investigate the prevalence and relationship of
smartphone addiction, nomophobia, and social anxiety among college and university
adolescents. A survey research was conducted among the targeted set for the collection of
data.

Sample

The sample of the current study would comprise of college and university
students (adolescents) (N = 1600). The sample was almost equally divided into girls (n =
800) and boys (n = 800). The age of the sample ranged from 17 to 30 years. The sample
will be approached using convenience sampling.

Instruments

According to nature of study, following three scales will be used, named

Smartphone Addiction Scale–Short Version (SAS-SV), Nomophobia Questionnaire
(NMP-Q) and Leibowitz Social Anxiety Scale (LSAS). The detailed description of these
scales is given below:

Smartphone Addiction Scale–Short Version (SAS-SV). Revised version of

Smartphone Addiction Scale (SAS-SV) is a scale to examine smartphone addiction. It
contains 6 factors and the factors are accessed through 10 items with a six-point Likert
scale (1: “strongly disagree”, 2: “disagree”, 3: “weakly disagree”, 4: “weakly agree”, 5:
“agree”, and 6: “strongly agree”) based on self-reporting (Kwon, Lee, Won, Park, Min, &
Hahn, 2013). The six factors are daily-life disturbance, positive anticipation, withdrawal,
cyberspace oriented relationship, overuse, and tolerance (Kwon et al., 2013). Kwon also
associated with other researchers to complete another study and concluded that the scores
are to total up to be measured. The cut-off value for boys was 31 and 33 for girls (Kwon,
Kim, Cho, & Yang, 2013). For those who scored higher than the cut-off values are
considered as high-risk for smartphone addiction. Cronbach's alpha coefficient of scale
was 0.91 (Kwon et al., 2013).
 20

Nomophobia Questionnaire (NMP-Q). The NMP-Q is a 20-item scale

developed by Yildirim and Correia (2015) .The NMP-Q comprises four factors (Factor 1:
not being able to communicate; Factor 2: losing connectedness; Factor 3: not being able
to access information; and Factor 4: giving up convenience). The Cronbach’s α was
excellent across the entire NMP-Q (α = .94) and in each factor (α = .81–.93). Concurrent
validity was achieved through its high correlation with Mobile Phone Involvement
Questionnaire (MPIQ; r = .71; Yildirim & Correia, 2015). A 7-point Likert scale ranging
from 1 (strongly disagree) to 7 (strongly agree) is applied to each NMP-Q item leading to
a summated total score. The higher the score, the greater the severity of nomophobia. In
addition, the interpretation of the NMP-Q score into the level of nomophobia (out of a
total score between 20 and 140) is 20 corresponding to the absence; 21–59 corresponding
to a mild level; 60–99 corresponding to a moderate level; and ≥100 corresponding to
severe level (Yildirim & Correia, 2015).

The Leibowitz Social Anxiety Scale (LSAS). Social anxiety scale was initially
developed by Leibowitz (1987). In the present study its translated version was used. The
scale comprised of 24 items. It is commonly used self-report measure of social anxiety
and included item depicting different social situation. For each situation individuals rates
their level of anxiety. The response format is 0 to 3. High score on this scale shows high
social anxiety. Items are divided into two sub scale; social performance and social
interaction situation. Cronbach’s alpha coefficient for LSAS total score was found to
be .96 Urdu version alpha reliability was .87 (Ozbay & Palanci, 2001).

Procedure

The study will be conducted in two steps. Firstly the scales will be translated in
Urdu through committee approach and psychometrics of scales will be ensured by
applying them on a small sample. For conducting the main study we will use the
convenience sampling. The students (university and college) will complete the informed
consent form, demographic information questionnaire and three other questionnaires used
in proposed study. After collecting data; suitable statistical analysis (e.g. t-test, ANOVA,
correlation and regression) will be applied by using Statistical Package for the Social
Sciences (SPSS) for testing the hypotheses. I will not physically harm any person. I will
 21

make sure that the respondents have been willingly participating in the research. Any
deception regarding objective of research will be avoided. The participants will be
assured that their privacy shall be kept confidence.

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