Reciprocal associations between smartphone overdependence and anxiety in adolescents: evidence from a nationally representative survey in the Republic of Korea
10.24171/j.phrp.2025.0510
- Author:
Eunok PARK
1
Author Information
1. College of Nursing and Health and Nursing Research Instutute, Jeju National University, Jeju, Republic of Korea
- Publication Type:Original Article
- From:
Osong Public Health and Research Perspectives
2026;17(1):72-82
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objectives:Smartphone overdependence (SOD) and anxiety are major concerns in adolescent mental health; however, few studies have examined their bidirectional relationship. This study aimed to examine reciprocal associations between SOD and anxiety among adolescents.
Methods:A secondary analysis was conducted with data from 50,975 adolescents in the 19th Korea Youth Risk Behavior Survey. SOD was measured using the SOD scale, and anxiety was assessed using the generalized anxiety disorder 7-item scale. Multivariable logistic regression analyses were conducted to examine reciprocal associations, adjusting for sociodemographic factors, perceived stress, loneliness, and depressive symptoms.
Results:Moderate to severe anxiety was found in 12.6% of participants, and 3.3% were classifiedas being at high risk for SOD. In adjusted models, the model with anxiety as the outcome demonstrated higher predictive performance (concordance rate, 86.5%) than the model with SOD as the outcome (77.3%). Adolescents at high risk for SOD had higher odds of reportinganxiety, and those with severe anxiety had higher odds of being classified as at high risk for SOD. Stress, loneliness, and smartphone use time were also identified as significant predictors.
Conclusion:SOD and anxiety were strongly associated with each other among adolescents.Integrated approaches addressing both digital behavior and mental health may help informstrategies to reduce psychological distress. Public health strategies may benefit fromconsidering both aspects when screening for problematic smartphone use and anxiety.
