A longitudinal study of the effects of problematic smartphone use on social functioning among people with schizophrenia: Mediating roles for sleep quality and self-stigma

Kun-Chia Chang¹, Yun-Husan Chang^{2

3}, Cheng-Fang Yen^{4

5

6}, Jung-Sheng Chen⁷, Po-Jen Chen⁸, Chung-Ying Lin^{9

10

11

12}, Mark D Griffiths¹³, Marc N Potenza^{14

15

16

17}, Amir H Pakpour¹⁸

Affiliations

¹ 1 Department of General Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan.
² 2 Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung, Taiwan.
³ 3 Health and Counseling Center, Office of Student Affairs, National Chung Hsing University, Taiwan.
⁴ 4 Department of Psychiatry, School of Medicine College of Medicine, Kaohsiung Medical University, Kaohsiung 802, Taiwan.
⁵ 5 Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 802, Taiwan.
⁶ 6 College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan.
⁷ 7 Department of Medical Research, E-Da Hospital, 824, Kaohsiung, Taiwan.
⁸ 8 Department of Medical Research, E-Da Hospital, Kaohsiung City 824005, Taiwan.
⁹ 9 Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan.
¹⁰ 10 Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan.
¹¹ 11 Department of Public Health, College of Medicine, National Cheng Kung University, 701401, Tainan, Taiwan.
¹² 12 Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan.
¹³ 13 International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK.
¹⁴ 14 Departments of Psychiatry and Neuroscience and the Child Study Center, School of Medicine, Yale University, New Haven, CT, USA.
¹⁵ 15 Connecticut Council on Problem Gambling, Wethersfield, CT, USA.
¹⁶ 16 Connecticut Mental Health Center, New Haven, CT, USA.
¹⁷ 17 Wu Tsai Institute, Yale University, New Haven, CT, USA.
¹⁸ 18 Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.

PMID: 35394922
PMCID: PMC9295235
DOI: 10.1556/2006.2022.00012

A longitudinal study of the effects of problematic smartphone use on social functioning among people with schizophrenia: Mediating roles for sleep quality and self-stigma

Kun-Chia Chang et al. J Behav Addict. 2022.

. 2022 Apr 7;11(2):567-576.

doi: 10.1556/2006.2022.00012. Online ahead of print.

Authors

Affiliations

¹ 1 Department of General Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan.
² 2 Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung, Taiwan.
³ 3 Health and Counseling Center, Office of Student Affairs, National Chung Hsing University, Taiwan.
⁴ 4 Department of Psychiatry, School of Medicine College of Medicine, Kaohsiung Medical University, Kaohsiung 802, Taiwan.
⁵ 5 Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 802, Taiwan.
⁶ 6 College of Professional Studies, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan.
⁷ 7 Department of Medical Research, E-Da Hospital, 824, Kaohsiung, Taiwan.
⁸ 8 Department of Medical Research, E-Da Hospital, Kaohsiung City 824005, Taiwan.
⁹ 9 Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan.
¹⁰ 10 Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan.
¹¹ 11 Department of Public Health, College of Medicine, National Cheng Kung University, 701401, Tainan, Taiwan.
¹² 12 Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan.
¹³ 13 International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK.
¹⁴ 14 Departments of Psychiatry and Neuroscience and the Child Study Center, School of Medicine, Yale University, New Haven, CT, USA.
¹⁵ 15 Connecticut Council on Problem Gambling, Wethersfield, CT, USA.
¹⁶ 16 Connecticut Mental Health Center, New Haven, CT, USA.
¹⁷ 17 Wu Tsai Institute, Yale University, New Haven, CT, USA.
¹⁸ 18 Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.

PMID: 35394922
PMCID: PMC9295235
DOI: 10.1556/2006.2022.00012

Abstract

Background and aims: Individuals with schizophrenia may often experience poor sleep, self-stigma, impaired social functions, and problematic smartphone use. However, the temporal relationships between these factors have not been investigated. The present study used a longitudinal design to examine potential mediating roles of poor sleep and self-stigma in associations between problematic smartphone use and impaired social functions among individuals with schizophrenia.

Methods: From April 2019 to August 2021, 193 individuals with schizophrenia (mean [SD] age = 41.34 [9.01] years; 88 [45.6%] males) were recruited and asked to complete three psychometric scales: the Smartphone Application-Based Addiction Scale to assess problematic smartphone use; the Pittsburgh Sleep Quality Index to assess sleep quality; and the Self-Stigma Scale-Short Scale to assess self-stigma. Social functioning was evaluated by a psychiatrist using the Personal and Social Performance Scale. All measures were assessed five times (one baseline and four follow-ups) at three-month intervals between assessments.

Results: General estimating equations found that problematic smartphone use (coefficient = -0.096, SE = 0.021; P < 0.001), sleep quality (coefficient = -0.134, SE = 0.038; P < 0.001), and self-stigma (coefficient = -0.612, SE = 0.192; P = 0.001) were significant statistical predictors for social functioning. Moreover, sleep quality and self-stigma mediated associations between problematic smartphone use and social functioning.

Conclusion: Problematic smartphone use appears to impact social functioning longitudinally among individuals with schizophrenia via poor sleep and self-stigma concerns. Interventions aimed at reducing problematic smartphone use, improving sleep, and addressing self-stigma may help improve social functioning among individuals with schizophrenia.

Keywords: addictive behaviors; internet addiction; schizophrenia; sleep; smartphone use; social function; stigma.

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Conflict of interest statement

The authors declare no conflict of interest.

The authors declare that they have no known competing financial interests or personal relationships relating to the publication of this manuscript. Dr. Potenza has consulted for and advised Opiant Pharmaceuticals, Idorsia Pharmaceuticals, AXA, Game Day Data and the Addiction Policy Forum; has been involved in a patent application with Yale University and Novartis; has received research support from the Mohegan Sun Casino, Connecticut Council on Problem Gambling and National Center for Responsible Gaming; has participated in surveys, mailings or telephone consultations related to drug addiction, impulse control disorders or other health topics; has contributed to a patent application for gambling and gaming disorder treatment; and has consulted for law offices and gambling entities on issues related to impulse control or addictive disorders.

Figures

**Fig. 1.**
Hypothesized mediation models investigating potential effects of sleep quality and self-stigma on associations between problematic smartphone use and social functioning. Solid lines indicate direct effects; dashed lines indicate mediated (indirect) effects

**Fig. 2.**
Mediational effects of sleep quality and self-stigma on associations between problematic smartphone use and social functioning among people with schizophrenia. LL = lower limit; UL = upper limit

See this image and copyright information in PMC

References

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A longitudinal study of the effects of problematic smartphone use on social functioning among people with schizophrenia: Mediating roles for sleep quality and self-stigma

Affiliations

A longitudinal study of the effects of problematic smartphone use on social functioning among people with schizophrenia: Mediating roles for sleep quality and self-stigma

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

LinkOut - more resources

Full Text Sources

Miscellaneous