Elhai JD, Levine JC, Hall BJ. (2019). The relationship between anxiety symptom severity and problematic smartphone use: A review of the literature and conceptual frameworks. Journal of Anxiety Disorders. 62: 45-52. doi: 10.1016/j.janxdis.2018.11.005
Researchers developed a framework to conceptualize interrelationships between problematic smartphone use (PSU) and anxiety symptom severity. The proposed framework was based on Compensatory Internet Use Theory, which states excessive internet use is used to relieve distress after stressful experiences, but rather than focus on PSU as a result of distress only, researchers conceptualized PSU as both a cause and a result of anxiety. The resulting framework proposed that anxiety leads to additional anxiety-related transdiagnostic factors (e.g., fear of missing out, rumination), which causes more frequent smartphone use, eventually becoming PSU, which in turn leads to anxiety. To evaluate evidence for the proposed framework, researchers conducted a literature search for articles examining relationships between anxiety and PSU severity, resulting in 28 articles. Most studies found positive relationships between anxiety and PSU severity with small to moderate effect sizes. Severity of PSU was positively related to several anxiety-related constructs, including anxiety sensitivity, rumination, fear of missing out, and proneness to boredom. Fear of missing out was also positively related to anxiety severity and mediated relationships between anxiety and PSU severity. Experimental research has found that excessive smartphone users experienced increased anxiety when separated from their smartphones. Prospective studies have found that anxiety sensitivity was a significant positive correlate to later PSU and that anxiety was inversely related to the number of screen unlocks. Researchers conclude the literature supports the proposed framework, providing evidence for the bidirectional relationship between anxiety and PSU severity and the role of anxiety-related transdiagnostic factors.