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Reciprocal associations between smartphone overdependence and anxiety in adolescents: evidence from a nationally representative survey in the Republic of Korea.

Osong public health and research perspectives · 2026 · Mixed · Moderate evidence

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MixedModerate evidencePaper 4331

Among adolescents, 3.3% were at high risk for smartphone overdependence and 12.6% had moderate to severe anxiety. High risk of smartphone overdependence was associated with higher odds of anxiety, and severe anxiety was associated with higher odds of smartpho…

Study snapshot

PublicationOsong public health and research perspectives · 2026
Study typecross_sectional
Reported directionMixed
Evidence ratingModerate

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 classified as 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 reporting anxiety, 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 inform strategies to reduce psychological distress. Public health strategies may benefit from considering both aspects when screening for problematic smartphone use and anxiety.

Machine Enhanced Logic

AI evidence extraction

Structured fields below were generated from the paper’s abstract and metadata to make the evidence easier to inspect. Automated extraction may be incomplete or incorrect; verify important details against the original paper.

Study typecross_sectional
Effect directionmixed
Populationadolescents in the Republic of Korea
Sample size50975
ExposureNot supplied
Evidence strengthModerateConfidence: 70% · Peer reviewed: yes

Main findings

Among adolescents, 3.3% were at high risk for smartphone overdependence and 12.6% had moderate to severe anxiety. High risk of smartphone overdependence was associated with higher odds of anxiety, and severe anxiety was associated with higher odds of smartphone overdependence. Stress, loneliness, and smartphone use time were also significant predictors.

Outcomes measured

  • smartphone overdependence
  • anxiety

Limitations

  • Cross-sectional design limits causal inference
  • Secondary data analysis with potential measurement limitations
View raw extracted JSON
{
  "study_type": "cross_sectional",
  "exposure": {
    "band": null,
    "source": "smartphone",
    "frequency_mhz": null,
    "sar_wkg": null,
    "duration": null
  },
  "population": "adolescents in the Republic of Korea",
  "sample_size": 50975,
  "outcomes": [
    "smartphone overdependence",
    "anxiety"
  ],
  "main_findings": "Among adolescents, 3.3% were at high risk for smartphone overdependence and 12.6% had moderate to severe anxiety. High risk of smartphone overdependence was associated with higher odds of anxiety, and severe anxiety was associated with higher odds of smartphone overdependence. Stress, loneliness, and smartphone use time were also significant predictors.",
  "effect_direction": "mixed",
  "limitations": [
    "Cross-sectional design limits causal inference",
    "Secondary data analysis with potential measurement limitations"
  ],
  "evidence_strength": "moderate",
  "confidence": 0.7,
  "peer_reviewed_likely": "yes",
  "keywords": [
    "smartphone overdependence",
    "anxiety",
    "adolescents",
    "mental health",
    "Korea",
    "digital behavior"
  ],
  "suggested_hubs": [
    {
      "slug": "smartphone-use",
      "weight": 0.9,
      "reason": "Focus on smartphone overdependence in adolescents"
    },
    {
      "slug": "mental-health",
      "weight": 0.8,
      "reason": "Study addresses anxiety and psychological distress"
    }
  ]
}
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AI-extracted fields are generated from the abstract and metadata and may be incomplete or incorrect. This material is for informational purposes and is not medical advice.

Identifiers and source

DOI: 10.24171/j.phrp.2025.0510
PubMed: 41664242

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