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. 2021 Jan;3(1):137-146.
doi: 10.1002/hbe2.227. Epub 2020 Nov 23.

Health anxiety related to problematic smartphone use and gaming disorder severity during COVID-19: Fear of missing out as a mediator

Jon D Elhai  1   2   3 , Dean McKay  4 , Haibo Yang  1 , Charlene Minaya  4 , Christian Montag  5   6 , Gordon J G Asmundson  7
Affiliations

Health anxiety related to problematic smartphone use and gaming disorder severity during COVID-19: Fear of missing out as a mediator

Jon D Elhai et al. Hum Behav Emerg Technol. 2021 Jan.

Abstract

Health anxiety has been linked with fear and anxiety regarding COVID-19. Higher levels of health anxiety likely increased social distancing and self-isolating during the pandemic. We investigated relations among health anxiety, fear of missing out (FOMO) on rewarding social experiences from social distancing, and consequential levels of problematic smartphone use (PSU) and gaming disorder (GD). We surveyed a broad sample of 812 U.S. and Canadian participants during the pandemic, in late-May 2020, using the Short Health Anxiety Inventory, FOMO Scale, Smartphone Addiction Scale-Short Version, and GD test. Significant bivariate relationships were found among health anxiety, FOMO, PSU, and GD severity. Using structural equation modeling, FOMO mediated relations between health anxiety and both PSU and GD severity. We discuss FOMO as an important variable explaining problematic digital technology use to compensate for unmet social needs from social distancing. We discuss these findings within the context of the Interaction of Person-Affect-Cognition-Execution theoretical model of problematic internet use. Results offer novel insight into the role of health anxiety on FOMO from unmet social needs during the COVID-19 pandemic, and consequential problematic internet use.

Keywords: COVID‐19; fear of missing out; gaming disorder; health anxiety; pandemics; problematic smartphone use.

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Conflict of interest statement

Dr J. D. E. notes that he receives royalties for several books published on posttraumatic stress disorder (PTSD); is a paid, full‐time faculty member at University of Toledo; is a paid, visiting scientist at Tianjin Normal University; occasionally serves as a paid, expert witness on PTSD legal cases; and receives grant research funding from the U.S. National Institutes of Health. Dr D. M. notes that he receives royalties for several books written on anxiety disorders in adults and children, obsessive–compulsive disorder, and research methodology; is a paid full‐time faculty member at Fordham University; holds a research fellow position in a joint relationship between Fordham University and Columbia University; and has private grant funding from a venture capital research corporation to investigate methods of reducing public speaking fears. Dr C. M. mentions that he has received (to Ulm University and earlier University of Bonn) grants from agencies such as the German Research Foundation (DFG). Dr C. M. has performed grant reviews for several agencies; has edited journal sections and articles; has given academic lectures in clinical or scientific venues or companies; and has generated books or book chapters for publishers of mental health texts. For some of these activities he received royalties, but never from the gaming or social media industry. Dr. C. M. mentions that he is part of a discussion circle (Digitalität und Verantwortung: https://about.fb.com/de/news/h/gespraechskreis-digitalitaet-und-verantwortung/) debating ethical questions linked to social media, digitalization, and society/democracy at Facebook. In this context, he receives no salary for his activities. Finally, he mentions that he currently functions as independent scientist on the scientific advisory board of the Nymphenburg group. This activity is financially compensated. Dr G. J. G. A. is the Editor‐in‐Chief of the Journal of Anxiety Disorders and Development Editor of Clinical Psychology Review. He receives financial support through payments for his editorial work on the aforementioned journals and royalties from various book publishers. He also currently hold research grants awarded by the Canadian Institutes of Health Research. The other authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Hypothesized model. FOMO, fear of missing out; GD, gaming disorder; Health Anx, Health Anxiety; Neg Cons, Perceived Negative Consequences of Illness (PNCI); PSU, problematic smartphone use. Latent variables are depicted with circles, while observed variables are depicted with rectangles. For visual simplicity, factor loading paths from the latent variables are not displayed
FIGURE 2
FIGURE 2
Correlation matrix of primary variables. FOMO, fear of missing out; GD, gaming disorder; Health Anx, Health Anxiety; Neg Cons, Perceived Negative Consequences of Illness (PNCI); PSU, problematic smartphone use. Correlations with a darker shade indicate stronger correlations, with blue indicating positive and red indicating negative correlations. All correlation ps < .001
FIGURE 3
FIGURE 3
Hypothesized model with standardized path coefficients. FOMO, fear of missing out; GD, gaming disorder; Health Anx, Health Anxiety; Neg Cons, Perceived Negative Consequences of Illness (PNCI); PSU, problematic smartphone use. Latent variables are depicted with circles, while observed variables are depicted with rectangles. SEs are displayed in parentheses. For visual simplicity, factor loading paths from the latent variables are not displayed, but estimates can be requested from the first author. Sex was coded “1” for men, and “2” for women. *p < .05, **p < .01, ***p < .001
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