The Relationship between Mental Health and Addiction to Mobile Phones among University Students of Shahrekord, Iran.

BACKGROUND: The risk of cell phone addiction is a social and psychological problem which has been proposed by psychologists, psychiatrists, and educational supervisors. The present study aimed to investigate the behavior of mobile phone addicts and mental health of university students of Shahrekord, Iran.
METHODS: This study was an applied research survey for the purposes of this study. The study population ýconsisted of all the students of Payame Noor University, Islamic Azad University, and University of Medical Sciences. The study population consisted of 296 students who were randomly selected from the target population. To collect data, two types of questionnaires were used, the Symptom Checklist-90-R(SCL-90-R) questionnaire, and the 32-point scale questionnaire of behavior associated with ýmobile phone use (Hooper and Zhou, 2007). Data analysis was performed using SPSS software, statistical analysis, frequency distribution, mean, one-way ANOVA, chi-square, and LSD (Least significance difference).
FINDINGS: The results showed that university students of Shahrekord, based on the six categories of mobile ýaddiction behaviors, were mostly placed in habitual behaviors (21.49%), addiction (21.49%), and intentional (21.49%) categories. By reviewing mental health indicators, it was found that students were affected with depressive disorder (17.30%), obsessive compulsive disorder (14.20%), and interpersonal sensitivity (13.80%). The results showed that there was a significant inverse relationship ýbetween mental health and habitual behaviors (r = -0.417), dependence (r = -0.317), addiction (r = -0.330), and incontinence (r = -0.309) in using mobile phone (P < 0.001).
CONCLUSION: Survey results showed that with increased and improved mental health, the student's rate of cell phone addiction reduced.

Introduction

The current era can be known as a combination of information and communication. Today, in possession of advanced information and communication technology, we are able to establish connections and exchange information faster than before.1 The most dominant type of information and communication technology is the mobile phone, the use of which in the past few years, due to social impact, has grown substantially. Mobile phone addiction, as a mental impairment resulting from modern technology, has come to the attention of psychologists, sociologists, and scholars of education. Troubled mobile phone use can be accounted a form of technological addiction.

Many mobile phone addicts are people with low self-esteem and poor social relationships; thus, they think they should be in constant contact with others. Mobile phone silence can lead to anxiety, irritability, sleep disturbances, shaking, insomnia, and digestive problems.2 From the perspective of Thomee et al. problematic and overuse of mobile phones is associated with anxiety, insomnia, depression, psychological distress, and unhealthy lifestyle.3 The emotional attachment to mobile phones for their users is in a way that makes them believe they cannot live without a cell phone. Researches have presented the negative impact of excessive use of mobile phones on physical and mental health of students.4 Medical research on the effects of mobile phone indicates that this means of communication does not act in order to maintain the health of its users. For example, results of a number of studies show that mobile phone radiation causes changes in gene regulation, auditory and visual problems, increased pressure of acid on the cornea and lens tissue, headache, heat sensation in the ears, memory loss, and fatigue.5-9 Studies also showed that prolonged use of cell phones cause brain tumors.10 In terms of psychology, communication technology reduces social relations and the welfare of the individual due to loneliness, depression, and isolation. Beydokhti ýet al. found that among adults and young people, the use of information and communication technology can lead to social anxiety and sleep disorders.11

From these contents it can be concluded that there is a relationship between addiction to mobile phones and physical and psychological health. In fact mental health includes behaving in harmony with the community, acceptance of social reality and the ability to cope with them, and satisfying one’s needs moderatly.12 Mental health according to the World Health Organization is a health condition in which a person knows their own abilities, can cope with the normal stresses of life, is fruitful for the community, and is able to make decisions and collective participation. Therefore, mental health is the base for welfare and health for individuals and society.

Hooper ýand Zhou, psychologists from Staffordshire University, studied 106 people who had used ýmobile phones, and found that 16.00% of them have behavioral problems. Their research concluded that behavioral problems followed by the addiction to cell phone use causes stress.12 Despite the importance of mobile phones in everyday life, research indicated that some people use this device uncontrollably and this has affected their personal lives.13 Review of research literature on the subject indicated that excessive use of mobile phones is a form of technology addiction. Results of the study by Hooper and Zhou showed that the rate of mobile phone use among university students is very high.12 There is a relatively high number of evidence for mandatory, voluntary, or dependent use of cell ýphones; however, habitual, compulsive, and addictive behaviors of mobile phone use are relatively ýless observed.

The findings of Shambare et al. showed that mobile phone use was mostly addictive, habitual, and dependent.14 The study of Ahmed et al. showed that a small number, less than 18.50%, of Pakistani students displayed mobile-related addictive behaviors. In this study the targeted subjects used mobile phones under reasonable conditions, and thus, did not have the tendency for addictive behaviors in mobile phone use.15 The results of several studies showed that addiction to text messages has a relationship with students’ social anxiety and nervousness, and personality traits of extraversion and neuroticism. Furthermore, the rate of addiction to text messages in different educational groups of students were different.1,11,16

Moreover, other studies showed a positive correlation between depression and anxiety and the amount of sent text messages in a day, and loss of control and social anxiety.17,18 Chen examined the relationship between depression and mobile phone addiction on 519 American students and concluded that there was a significant association between mobile phone addiction symptoms (distraction, withdrawal, and escape) and depression. In addition, he stated that women had significantly higher rates of mobile phone addiction symptoms compared to men.19

Technology addiction in general and dependency on cell phones in particular are important for several reasons. Despite the advantages and necessity of technologies for human society, due to their stimulating factors, they results in excessive use and lead to addiction. Young people are more vulnerable to excessive phone use, and thus, become phone dependent.20 Young people’s mental health, addiction to mobile phones, as a driving force, and an active community is major topics that are discussed in psychology and sociology. The present study addressed the question of whether there is any relationship between the amount and type of cell phone addiction and mental health status of university students in Shahrekord, Iran.

Methods

Due to the purpose of this study, this research was an applied research survey. The study population consisted of all students in different universities of Shahrekord (Islamic Azad University, Payame Noor University, and University of Medical Sciences). From among the target population, 296 subjects were randomly selected. Two types of questionnaires were used to collect data that include the Symptom Checklist-90-R (SCL-90-R) questionnaire, and 32-point scale questionnaire of behavior associated with mobile phone use (Hooper and Zhou, 2007).12 The SCL-90-R questionnaire has been used in many researches in Iran and outside Iran, and has a high reliability.12,21-23 The validity and reliability of the mobile phone use questionnaire in some researches was at a high level.13,19 In order to analyze the collected data, SPSS for Windows (version 18, SPSS Inc., Chicago, IL, USA) was used. The Pearson correlation analysis, Student’s independent t-test, and chi-square test were used for data analysis. From the total of 296 students who participated in the study, 57.10% were men, 49.90% were female, 14.90% were single, 85.10% were married, 34.80% were living in a dormitory, and 65.20% lived elsewhere. Moreover, 50.30% studied in public Universities of Medical Sciences, 32.80% studied in Payame Noor University, and 16.90% enrolled in Islamic Azad University.

Results

Based on the results of table 1, the majority of students, according to the categories of addictive behaviors of mobile phone, were placed in the three categories of habitual behaviors (21.49%), voluntary behaviors (21.49%), and dependent behaviors (21.49%). Based on the results of table 2, students, with regard to mental health, had higher rates of depression (17.30%), obsessive-compulsive disorder (OCD) (14.20%), and interpersonal sensitivity (13.80%). Results showed that with confidence interval of 0.99 and P < 0.001, there was a relationship between mental health and four out of six categories of mobile phone addiction (habitual behaviors, dependent behaviors, addictive behaviors, and involuntary behaviors). In fact, only at the level of voluntary and compulsive behaviors there was no significant relationship with students' mental health. The results showed that with confidence interval of 0.99 and P < 0.001, there was a significant negative relationship between mental health and general behavior of addiction to mobile phones. This means that as the rate of mobile addiction becomes less, the students’ mental health increases. Table 3 presented phone addictive behaviors that have a significant relationship with mental health. Based on these results, mental health of university students of Shahrekord did not differ according to demographic factors (gender, type of university, type of residence, education, and marital status).

Table 1

Ranking mobile phone addiction in terms of defined behaviors (n = 296)

Description	Percentage
Habitual behavior	21.49
Voluntary behavior	21.49
Dependent behavior	21.49
Involuntary behavior	16.53
Compulsive behavior	16.53
Addictive behavior	15.70

Table 2

Ranking mental health in terms of study dimensions

Description	Percentage
Depression	17.30
OCD	14.20
Interpersonal sensitivity	13.80
Anxiety	11.60
Psychosis	10.88
Hypochondrias	10.46
Paranoia	10.39
Hostility	6.05
Phobias	5.22

OCD: Obsessive-compulsive disorder

Table 3

The relationship between mobile phone addiction behavior and mental health

Types of addictive behaviors toward mobile phone	Correlation coefficient with mental health
Habitual	-0.417*
Voluntary	-0.011
Dependent	-0.317*
Involuntary	-0.309*
Mandatory	-0.060
Addictive behaviors	-0.330*
General addictive behavior toward mobile phones	-0.383*

Correlation is significant at the 0.01 level (2-tailed)

Discussion

The results of this study showed that university students of Shahrekord, based on the six categories of mobile phone addictive behaviors, were mostly placed in categories of habitual, voluntary, and dependent behaviors with 20.30%. These finding were consistent with results of several studies.12,17-20 As was noted in the findings section, there was a significant inverse relationship between mobile phone addiction and mental health. Findings show that the highest correlation was related to mental health and habitual behaviors. Habitual behaviors refer to behaviors that are formed from habit, without hesitation, thought, and mental awareness in order to achieve a particular purpose.17 Students who suffer from lower mental health, usually when faced with a challenge, a problem, or an assignment or a specific purpose, feel helpless, frustrated, and powerless. As a result, to counteract these negative feelings, they turn to their previous habits involuntarily and automatically, such as mobile phone contacts, and with this they reduce their anxiety and worry due to their inefficiencies. It was observed that after habitual behaviors, addictions and dependent behaviors have the highest negative correlation with mental disorder. One of the most important causes of this serious relationship probably depends on the nature of addictive and dependent behaviors. Addictive behavior refers to a sudden and involuntary tendency to do a particular act or behavior, in the state of psychological imbalance, and the main factors that drive this conflict and psychological imbalance are irrational negative, inner thoughts.12,21-23 Hence, it seems that students with lower mental health and psychological balance, are more vulnerable to addictive mobile phones use, because they try to reduce their internal tensions by talking to others. On the other hand, students who had average and high mental health levels also had some types of addiction to mobile phones (habitual addiction). This could be related to excessive use of mobile phones for long-distance calls to family members. Another factor is the lack of entertainment and addiction to entertainment and games that are available on mobile phones. Factors such as jealousy, personality characteristics, the presence or absence of metacognitive skills such as self-regulation skills, and financial considerations could be other factors for the usage or non-usage of cell phones.21-23 Further research on the relationship between these factors and mobile phone addiction is recommended.

The results showed that between mental health and addictive behaviors toward mobile phones there was a significant inverse relationship in the categories of dependent, involuntary, and addiction behaviors. In other words, in higher mental health, human behavior is more rational, and the amount of cell phone addiction reduces. These findings were consistent with results from a number of studies such as Thomee et al.,3 Chen,19 Billieux et al.,17 Park et al.,18Hassanzadeh and Rezaei,1 Golmohammadian and Yaseminejad,24 and Seyed Ali.25 Research results indicate that there is a relationship between addiction to mobile phone and mental health in dimensions of behavioral problems, anxiety, depression, and psychosis. In addition, the results showed that there was no relationship between the occurrence of behaviors of cell phone addiction and gender, type of residence, type of university, and the study filed. These findings were consistent with results of Koo and Park,26 Pawlowska and Potembska,27 Wei,28 and Wilska,29 and domestic research, including Zamani et al.21-23 The investigation showed that there was a relationship between mobile phone addictive behavior and gender-related factors. Furthermore, there was a relationship between habitual behaviors of mobile phone use and marital status, addictive behaviors, and university. However, the results indicated that there was no significant relationship between mental health and gender, marital status, type of residence, university, and field of study.

Conclusion

Survey results showed that with increased and improved mental health, the rates of students’ addiction to mobile phones reduced. Hence, it is necessary to take more steps in developing recreational programs for students’ leisure time to maintain students’ mental health, and thereby decrease addiction to a variety of new digital media such as the Internet, chat rooms, computer games, and mobile phones. Therefore, it is necessary that the university authorities and higher education institutions develop training programs, and make efforts to maintain physical and mental health of students.