Post-traumatic stress disorder (PTSD) symptoms are associated with addictive behaviors including problematic smartphone use (PSU). Drawing from existing theoretical models and empirical work, we examined the relation between PTSD symptoms, social/process-oriented smartphone feature uses, and PSU. Specifically, we examined the correlations between social/process-oriented smartphone feature uses with both PTSD symptom clusters (intrusions, avoidance, negative alterations in cognitions and mood, alterations in arousal and reactivity) and PSU and the mediating role of social/process-oriented smartphone feature uses in the relation between PTSD symptom clusters and PSU. The current study used data from a sample of 347 community participants recruited through Amazon’s Mechanical Turk platform. Correlation results indicated that process-oriented smartphone feature uses correlated significantly (positively) with all the PTSD symptom clusters and PSU. Further, mediation results indicated that process-oriented smartphone feature use significantly mediated the relationship between each PTSD symptom cluster and PSU. Beyond highlighting the role of process-oriented smartphone feature uses (e.g., watching videos/TV/movies, reading books/magazines, games) in the relation between PTSD symptoms and PSU, our findings suggest that efforts to reduce PSU among individuals with PTSD symptoms should integrate strategies for reducing process-oriented uses of smartphones.
AkınA.AltundağY.TuranM. E.AkınU. (2014). The validity and reliability of the Turkish version of the smart phone addiction scale-short form for adolescent. Procedia-Social and Behavioral Sciences, 152, 74–77.
2.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: Author.
3.
BadourC. L.BlonigenD. M.BodenM. T.FeldnerM. T.Bonn-MillerM. O. (2012). A longitudinal test of the bi-directional relations between avoidance coping and PTSD severity during and after PTSD treatment. Behavior Research and Therapy, 50, 610–616.
4.
BakerT. B.PiperM. E.McCarthyD. E.MajeskieM. R.FioreM. C. (2004). Addiction motivation reformulated: An affective processing model of negative reinforcement. Psychological Review, 111, 33–55.
5.
BianchiA.PhillipsJ. G. (2005). Psychological predictors of problem mobile phone use. Cyber Psychology & Behavior, 8, 39–51.
6.
BillieuxJ. (2012). Problematic use of the mobile phone: A literature review and a pathways model. Current Psychiatry Reviews, 8, 299–307.
7.
BillieuxJ.MaurageP.Lopez-FernandezO.KussD. J.GriffithsM. D. (2015). Can disordered mobile phone use be considered a behavioral addiction? An update on current evidence and a comprehensive model for future research. Current Addiction Reports, 2, 156–162.
8.
BillieuxJ.Van Der LindenM.D’AcremontM.CeschiG.ZermattenA. (2007). Does impulsivity relate to perceived dependence and actual use of the mobile phone?Applied Cognitive Psychology, 21, 527–537.
9.
BillieuxJ.Van Der LindenM.RochatL. (2008). The role of impulsivity in actual and problematic use of the mobile phone. Applied Cognitive Psychology, 22, 1195–1210.
10.
BlevinsC. A.WeathersF. W.DavisM. T.WitteT. K.DominoJ. L. (2015). The posttraumatic stress disorder checklist for DSM-5 (PCL-5): Development and initial psychometric evaluation. Journal of Traumatic Stress, 28, 489–498.
11.
BollenK. A.StineR. (1990). Direct and indirect effects: Classical and bootstrap estimates of variability. Sociological Methodology, 20, 115–140.
12.
BovinM. J.MarxB. P.WeathersF. W.GallagherM. W.RodriguezP.…KeaneT. M. (2016). Psychometric properties of the PTSD checklist for diagnostic and statistical manual of mental disorders–Fifth Edition (PCL-5) in veterans. Psychological Assessment, 28, 1379–1391.
13.
BuhrmesterM.KwangT.GoslingS. D. (2011). Amazon’s Mechanical Turk a new source of inexpensive, yet high-quality, data?Perspectives on Psychological Science, 6, 3–5.
14.
CheeverN. A.RosenL. D.CarrierL. M.ChavezA. (2014). Out of sight is not out of mind: The impact of restricting wireless mobile device use on anxiety levels among low, moderate and high users. Computers in Human Behavior, 37, 290–297.
15.
ChenY. F.KatzJ. E. (2009). Extending family to school life: College students’ use of the mobile phone. International Journal of Human–Computer Interaction, 67, 179–191.
16.
ChengY.LiangJ.LeungL. (2015). Social network service use on mobile devices: An examination of gratifications, civic attitudes and civic engagement in China. New Media & Society, 17, 1096–1116.
17.
ChouC.HsiaoM. C. (2000). Internet addiction, usage, gratification, and pleasure experience: The Taiwan college students’ case. Computers & Education, 35, 65–80.
18.
ClaessonK.SohlbergS. (2002). Internalized shame and early interactions characterized by indifference, abandonment and rejection: Replicated findings. Clinical Psychology & Psychotherapy, 9, 277–284.
19.
ClaytonR. B.LeshnerG.AlmondA. (2015). The extended iSelf: The impact of iPhone separation on cognition, emotion, and physiology. Journal of Computer-Mediated Communication, 20, 119–135.
20.
ContractorA. A.ArmourC.ForbesD.ElhaiJ. D. (2016). PTSD’s underlying dimensions and their relation with impulsivity facets. The Journal of Nervous & Mental Disease, 204, 20–25.
21.
ContractorA. A.FrankfurtS.WeissN. H.ElhaiJ. D. (2017). Latent-level relations between DSM-5 PTSD symptom clusters and problematic smartphone use. Computers in Human Behavior, 72, 170–177.
22.
ContractorA. A.WeissN. H.TullM. T.ElhaiJ. D. (2017). PTSD’s relation with problematic smartphone use: Mediating role of impulsivity. Computers in Human Behavior, 75, 177–183.
23.
CurranP. J.WestS. G.FinchJ. F. (1996). The robustness of test statistics to nonnormality and specification error in confirmatory factor analysis. Psychological Methods, 1, 16–29.
24.
DemirciK.AkgönülM.AkpinarA. (2015). Relationship of smartphone use severity with sleep quality, depression, and anxiety in university students. Journal of Behavioral Addictions, 4, 85–92.
25.
DhirA.ChenG. M.ChenS. (2017). Why do we tag photographs on Facebook? Proposing a new gratifications scale. New Media & Society, 19, 502–521.
26.
DhirA.ChenS.NieminenM. (2015a). Predicting adolescent Internet addiction: The roles of demographics, technology accessibility, unwillingness to communicate and sought internet gratifications. Computers in Human Behavior, 51, 24–33.
27.
DhirA.ChenS.NieminenM. (2015b). Psychometric validation of the Chinese compulsive internet use scale (CIUS) with Taiwanese high school adolescents. Psychiatric Quarterly, 86, 581–596.
28.
DhirA.ChenS.NieminenM. (2015c). A repeat cross-sectional analysis of the psychometric properties of the Compulsive Internet Use Scale (CIUS) with adolescents from public and private schools. Computers & Education, 86, 172–181.
29.
DhirA.ChenS.NieminenM. (2017). Development and validation of the Internet gratification scale for adolescents. Journal of Psychoeducational Assessment, 35, 361–376.
30.
DhirA.KaurP.LonkaK.TsaiC. C. (2017). Do psychosocial attributes of well-being drive intensive Facebook use?Computers in Human Behavior, 68, 520–527.
31.
DhirA.TorsheimT. (2016). Age and gender differences in photo tagging gratifications. Computers in Human Behavior, 63, 630–638.
32.
DhirA.TsaiC. C. (2017). Understanding the relationship between intensity and gratifications of Facebook use among adolescents and young adults. Telematics and Informatics, 34, 350–364.
33.
DimmickJ.SikandJ.PattersonS. (1994). The gratifications of the household telephone. Sociability, instrumentality, and reassurance. Communication Research, 21, 641–651.
34.
DolanR.ConduitJ.FahyJ.GoodmanS. (2016). Social media engagement behaviour: A uses and gratifications perspective. Journal of Strategic Marketing, 24, 261–277.
35.
ElhaiJ. D.ContractorA. A. (2018). Examining latent classes of smartphone users: Relations with psychopathology and problematic smartphone use. Computers in Human Behavior, 82, 159–166.
36.
ElhaiJ. D.DvorakR. D.LevineJ. C.HallB. J. (2017). Problematic smartphone use: A conceptual overview and systematic review of relations with anxiety and depression psychopathology. Journal of Affective Disorders, 207, 251–259.
37.
ElhaiJ. D.HallB. J.LevineJ. C.DvorakR. D. (2017). Types of smartphone usage and relations with problematic smartphone behaviors: The role of content consumption vs. social smartphone use. Cyberpsychology: Journal of Psychosocial Research on Cyberspace, 11(2).
38.
ElhaiJ. D.LevineJ. C.DvorakR. D.HallB. J. (2016). Fear of missing out, need for touch, anxiety and depression are related to problematic smartphone use. Computers in Human Behavior, 63, 509–516.
39.
ElhaiJ. D.LevineJ. C.DvorakR. D.HallB. J. (2017). Non-social features of smartphone use are most related to depression, anxiety and problematic smartphone use. Computers in Human Behavior, 69, 75–82.
40.
ElhaiJ. D.MillerM. E.FordJ. D.BiehnT. L.PalmieriP. A.FruehB. C. (2012). Posttraumatic stress disorder in DSM-5: Estimates of prevalence and symptom structure in a nonclinical sample of college students. Journal of Anxiety Disorders, 26, 58–64.
41.
ElhaiJ. D.TiamiyuM. F.WeeksJ. W.LevineJ. C.PicardK. J.HallB. J. (2018). Depression and emotion regulation predict objective smartphone use measured over one week. Personality and Individual Differences, 135, 21–28.
42.
EzoeS.TodaM.YoshimuraK.NaritomiA.DenR.MorimotoK. (2009). Relationships of personality and lifestyle with mobile phone dependence among female nursing students. Social Behavior and Personality: An International Journal, 37, 231–238.
43.
FischerS.SmithG. T.SpillaneN.CydersM. A. (2005). Individual differences in reaction to mood and implications for addictive behaviors. In ClarkA. V. (Ed.), The Psychology of Mood (pp. 85–107). New York, NY: Nova Science.
44.
FisherL. A.EliasJ. W.RitzK. (1998). Predicting relapse to substance abuse as a function of personality dimensions. Alcoholism: Clinical and Experimental Research, 22, 1041–1047.
45.
FoaE. B.RothbaumB. O. (1985). Treating the trauma of rape: Cognitive–behavioral therapy for PTSD. New York, NY: Guilford Press.
46.
GilbertP.PehlJ.AllanS. (1994). The phenomenology of shame and guilt: An empirical investigation. Psychology and Psychotherapy: Theory, Research and Practice, 67, 23–36.
47.
GoodmanL. A.CorcoranC.TurnerK.YuanN.GreenB. L. (1998). Assessing traumatic event exposure: General issues and preliminary findings for the stressful life events screening questionnaire. Journal of Traumatic Stress, 11, 521–542.
48.
GreenB. L.KorolM.GraceM. C.VaryM. G.LeonardA. C.…Smitson-CohenS. (1991). Children and disaster: Age, gender, and parental effects on PTSD symptoms. Journal of American Academy of Child and Adolescent Psychiatry, 30, 945–951.
49.
HayesS. C.WilsonK. G.GiffordE. V.FolletteV. M.StrosahlK. (1996). Experiential avoidance and behavioral disorders: a functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64, 1152–1168.
50.
HoffnerC. A.LeeS. (2015). Mobile phone use, emotion regulation, and wellbeing. Cyberpsychology, Behavior, and Social Networking, 18, 411–416.
51.
JeongS. H.KimH.YumJ. Y.HwangY. (2016). What type of content are smartphone users addicted to? SNS vs. games. Computers in Human Behavior, 54, 10–17.
52.
KaganJ. (2001). Temperamental contributions to affective and behavioral profiles in childhood. In HofmannS. G.DiBartoloP. M. (Eds.), From social anxiety to social phobia: Multiple perspectives (pp. 216–234). Boston, MA: Allyn & Bacon.
53.
Kardefelt-WintherD. (2014). A conceptual and methodological critique of internet addiction research: Towards a model of compensatory internet use. Computers in Human Behavior, 31, 351–354.
54.
KatzE.BlumlerJ.GurevitchM. (1974). Uses of mass communications by the individual. In DavidsonW.YuF. (Eds.), Mass communication research: Major issues and future directions (pp. 11–35). New York, NY: Praeger.
55.
KeaneT. M.WolfeJ. (1990). Comorbidity in post-traumatic stress disorder. An analysis of community and clinical studies. Journal of Applied Social Psychology, 20, 1776–1788.
56.
KhantzianE. J. (1985). The self-medication hypothesis of addictive disorders. American Journal of Psychiatry, 142, 1259–1264.
57.
KrautR.OlsonJ.BanajiM.BruckmanA.CohenJ.CouperM. (2004). Psychological research online: Report of board of scientific affairs’ advisory group on the conduct of research on the internet. American Psychologist, 59, 105–117.
58.
KussD. J.GriffithsM. D. (2011). Online social networking and addiction—A review of the psychological literature. International Journal of Environmental Research and Public Health, 8, 3528–3552.
59.
KwonM.KimD. J.ChoH.YangS. (2013). The smartphone addiction scale: Development and validation of a short version for adolescents. PloS One, 8, e83558.
60.
KwonM.LeeJ. Y.WonW. Y.ParkJ. W.MinJ. A.…KimD. J. (2013). Development and validation of a smartphone addiction scale (SAS). PloS One, 8, e56936.
61.
LeeY. K.ChangC. T.LinY.ChengZ. H. (2014). The dark side of smartphone usage: Psychological traits, compulsive behavior and technostress. Computers in Human Behavior, 31, 373–383.
62.
LewisH. B. (1971). Shame and guilt in neurosis. Psychoanalytic Review, 58, 419–438.
63.
LinC. (1999). Online service adoption likelihood. Journal of Advertising Research, 39, 78–89.
64.
LongJ.LiuT. Q.LiaoY. H.QiC.HeH. Y.…BillieuxJ. (2016). Prevalence and correlates of problematic smartphone use in a large random sample of Chinese undergraduates. BMC Psychiatry, 16, 408.
65.
Lopez-FernandezO.Honrubia-SerranoL.Freixa-BlanxartM.GibsonW. (2014). Prevalence of problematic mobile phone use in British adolescents. Cyberpsychology, Behavior, and Social Networking, 17, 91–98.
66.
MacKinnonD. P.FairchildA. J.FritzM. S. (2007). Mediation analysis. Annual Review of Psychology, 58, 593–614.
67.
MacKinnonD. P.LockwoodC. M.HoffmanJ. M.WestS. G.SheetsV. (2002). A comparison of methods to test mediation and other intervening variable effects. Psychological Methods, 7, 83–104.
68.
MalikA.DhirA.NieminenM. (2016). Uses and gratifications of digital photo sharing on Facebook. Telematics and Informatics, 33, 129–138.
69.
MarlattG. A.BaerJ. S.DonovanD. M.KivlahanD. R. (1988). Addictive behaviors: Etiology and treatment. Annual Review of Psychology, 39, 223–252.
70.
Marshall-BerenzE. C.VujanovicA. A.MacPhersonL. (2011). Impulsivity and alcohol use coping motives in a trauma-exposed sample: The mediating role of distress tolerance. Personality and Individual Differences, 50, 588–592.
71.
MischraS.CarletonN. (2017). Use of online crowdsourcing platforms for gambling research. International Gambling Studies, 17, 125–43.
72.
MonsonC. M.TaftC. T.FredmanS. J. (2009). Military-related PTSD and intimate relationships: From description to theory-driven research and intervention development. Clinical Psychological Review, 29, 707–714.
73.
MuthénL. K.MuthénB. O. (1998–2011). Mplus user’s guide. (6th ed.). Los Angeles, CA: Author.
74.
NorrisF. H.KaniastyK.ConradM. L.InmanG. L.MurphyA. D. (2002). Placing age differences in cultural context: A comparison of the effects of age on PTSD after disasters in the United States, Mexico, and Poland. Journal of Clinical Geropsychology, 8, 153–173.
75.
OrsilloS. M.HeimbergR. G.JusterH. R.GarrettJ. (1996). Social phobia and PTSD in Vietnam veterans. Journal of Traumatic Stress, 9, 235–252.
76.
OrsilloS. M.WeathersF. W.LitzB. T.SteinbergH. R.KeaneT. M. (1996). Current and lifetime psychiatric disorders among veterans with war zone-related posttraumatic stress disorder. The Journal of Nervous & Mental Disease, 184, 307–313.
77.
RettieR. (2008). Mobile phones as network capital: Facilitating connections. Mobilities, 3, 291–311.
78.
RiggsD. S.ByrneC. A.WeathersF. W.LitzB. T. (1998). The quality of the intimate relationships of male Vietnam veterans: Problems associated with posttraumatic stress disorder. Journal of Traumatic Stress, 11, 87–101.
79.
RobertsJ. A.PulligC.ManolisC. (2015). I need my smartphone: A hierarchical model of personality and cell-phone addiction. Personality and Individual Differences, 79, 13–19.
80.
RobinsonT. E.BerridgeK. C. (2000). The psychology and neurobiology of addiction: An incentive-sensitization view. Addiction, 95, S91–S117.
81.
RoleyM. E.ContractorA. A.WeissN. H.ArmourC.ElhaiJ. D. (2017). Impulsivity facets’ predictive relations with DSM-5 PTSD symptom clusters. Psychological Trauma Theory Research Practice and Policy, 9, 76–79.
82.
ShafferH. J. (1996). Understanding the means and objects of addiction: Technology, the internet, and gambling. Journal of Gambling Studies, 12, 461–469.
83.
ShapiroD. N.ChandlerJ.MuellerP. A. (2013). Using Mechanical Turk to study clinical populations. Clinical Psychological Science, 1, 213–220.
84.
SkanlandM. S. (2011). Use of mp3-players as a coping resource. Music & Arts in Action, 3, 15–33.
85.
SongI.LaroseR.EastinM. S.LinC. A. (2004). Internet gratifications and Internet addiction: On the uses and abuses of new media. CyberPsychology & Behavior, 7, 384–394.
86.
StewartS. H. (1996). Alcohol abuse in individuals exposed to trauma: A critical review. Psychological Bulletin, 120, 83–112.
87.
TolinD. F.FoaE. B. (2006). Sex differences in trauma and posttraumatic stress disorder: A quantitative review of 25 years of research. Psychological Bulletin, 132, 959–992.
88.
TullM. T.WeissN. H.McDermottM. J. (2015). Posttraumatic stress disorder and impulsive and risky behavior: An overview and discussion of potential mechanisms. In MartinC. R.PreedyV. R.PatelV. B. (Eds.), Comprehensive guide to post-traumatic stress disorders (pp. 803–816). New York, NY: Springer.
89.
van DeursenA. J.BolleC. L.HegnerS. M.KommersP. A. (2015). Modeling habitual and addictive smartphone behavior: The role of smartphone usage types, emotional intelligence, social stress, self-regulation, age, and gender. Computers in Human Behavior, 45, 411–420.
90.
ViolantiJ. M. (1998). Cellular phones and fatal traffic collisions. Accident Analysis & Prevention, 30, 519–524.
91.
WangJ. L.WangH. Z.GaskinJ.WangL. H. (2015). The role of stress and motivation in problematic smartphone use among college students. Computers in Human Behavior, 53, 181–188.
92.
WeathersF. W.LitzB. T.KeaneT. M.PalmieriP. A.…SchnurrP. P. (2013). The PTSD checklist for DSM-5 (PCL-5). Scale Retrieved from the National center for PTSD athttp://www.ptsd.va.gov
93.
WeissN. H.TullM. T.SullivanT. P.Dixon-GordonK. L.GratzK. L. (2015). Posttraumatic stress disorder symptoms and risky behaviors among trauma-exposed inpatients with substance dependence: The influence of negative and positive urgency. Drug and Alcohol Dependence, 155, 147–153.
94.
WeissN. H.TullM. T.VianaA. G.AnestisM. D.GratzK. L. (2012). Impulsive behaviors as an emotion regulation strategy: Examining associations between PTSD, emotion dysregulation, and impulsive behaviors among substance dependent inpatients. Journal of Anxiety Disorders, 26, 453–458.
95.
WhangL. S.LeeS.ChangG. (2003). Internet over-users’ psychological profiles: A behavior sampling analysis on Internet addiction. CyberPsychology Behavior, 6, 143–150.
96.
WilliamsD.KennedyT. L.MooreR. J. (2011). Behind the avatar: The patterns, practices, and functions of role playing in MMOs. Games and Culture, 6, 171–200.
97.
WortmannJ. H.JordanA. H.WeathersF. W.ResickP. A.DondanvilleK. A.…LitzB. T. (2016). Psychometric analysis of the PTSD checklist-5 (PCL-5) among treatment-seeking military service members. Psychological Assessment, 28, 1392–1403.
98.
YangS. C.TungC. J. (2007). Comparison of internet addicts and non-addicts in Taiwanese high school. Computers in Human Behavior, 23, 79–96.
99.
ZayfertC.DeVivaJ. C.HofmannS. G. (2005). Comorbid PTSD and social phobia in a treatment-seeking population: An exploratory study. The Journal of Nervous & Mental Disease, 193, 93–101.
100.
Zhitomirsky-GeffetM.BlauM. (2016). Cross-generational analysis of predictive factors of addictive behavior in smartphone usage. Computers in Human Behavior, 64, 682–693.
