Follow-up study on the association of anxiety and depressive symptoms with smartphone addiction among middle school students

JI Mingxia; YANG Jie; JIA Qu; DONG Ying; WANG Daosen; LI Zhumin; WEN Xiang; CHEN Qifei; LI Xiuhong

doi:10.16835/j.cnki.1000-9817.2025223

Volume 46 Issue 9

Sep. 2025

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Article Navigation > CHINESE JOURNAL OF SCHOOL HEALTH > 2025 > 46(9): 1277-1281

JI Mingxia, YANG Jie, JIA Qu, DONG Ying, WANG Daosen, LI Zhumin, WEN Xiang, CHEN Qifei, LI Xiuhong. Follow-up study on the association of anxiety and depressive symptoms with smartphone addiction among middle school students[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2025, 46(9): 1277-1281. doi: 10.16835/j.cnki.1000-9817.2025223

Citation:

JI Mingxia, YANG Jie, JIA Qu, DONG Ying, WANG Daosen, LI Zhumin, WEN Xiang, CHEN Qifei, LI Xiuhong. Follow-up study on the association of anxiety and depressive symptoms with smartphone addiction among middle school students[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2025, 46(9): 1277-1281. doi: 10.16835/j.cnki.1000-9817.2025223

Citation:

JI Mingxia, YANG Jie, JIA Qu, DONG Ying, WANG Daosen, LI Zhumin, WEN Xiang, CHEN Qifei, LI Xiuhong. Follow-up study on the association of anxiety and depressive symptoms with smartphone addiction among middle school students[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2025, 46(9): 1277-1281. doi: 10.16835/j.cnki.1000-9817.2025223

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Follow-up study on the association of anxiety and depressive symptoms with smartphone addiction among middle school students

doi: 10.16835/j.cnki.1000-9817.2025223

1.
Institute of Educational Science of Guangming Branch, Shenzhen 518000, Guangdong Province, China

Received Date: 2025-03-19
Rev Recd Date: 2025-05-01

Available Online: 2025-10-10

Publish Date: 2025-09-25

Abstract

Abstract

Objective To investigate the changing trends for associations of anxiety and depressive symptoms with smartphone addiction among middle school students, so as to provide a scientific basis for preventing smartphone addiction in middle school students. Methods From 2022 to 2023, a method of combining convenient sampling with cluster sampling was used to select 8 923 middle school students from 27 junior high schools and 3 senior high schools in a district of Shenzhen City between September 2022 (baseline, T1) and September 2023 (follow-up, T2). The Smartphone Addiction Scale-Short Version (SAS-SV), Patients Health Questionnaire-9 Item (PHQ-9), and Generalized Anxiety Disorder 7-item Scale (GAD-7) were administered to assess smartphone addiction, anxiety and depressive symptoms. Mixed-effects models were used to analyze the association of anxiety and depressive symptoms with smartphone addiction among middle school students. Results From September 2022 to September 2023, the reported prevalence of smartphone addiction increased from 24.22% to 25.25% (χ²=45.71); and smartphone addiction scores [24.00(16.00, 32.00), 25.00(16.00, 33.00)], anxiety symptom scores [2.00(0.00, 7.00), 3.00(0.00, 7.00)] and depressive symptom scores[3.00(0.00, 8.00), 5.00(0.00, 9.00)] all significantly increased (Z=-17.43, -42.38, -41.57) (all P < 0.05). There were statistically significant difference in the distribution of anxiety and depression symptom levels among middle school students in 2022 and 2023 (χ²=85.15, 106.85, both P < 0.05). After adjusting for covariates such as age, gender and family background, mixed-effects models revealed dose-response associations of anxiety and depressive symptoms with smartphone addiction among middle school students: mild anxiety symptom(OR=3.22), moderate-to-severe anxiety symptom (OR=5.36), mild depressive symptom (OR=3.32) and moderate-to-severe depressive symptom (OR=6.13) were significantly associated with higher risks of smartphone addiction (all P < 0.05). Interaction effect analysis found that co-existing anxiety and depressive symptoms synergistically increased addiction risk by 5.60 times (OR=5.60) compared to the asymptomatic group, with 32% of the combined risk attributable to their interaction (S=1.64, AP=0.32)(both P < 0.05). Conclusions Anxiety and depressive symptoms are significantly associated with smartphone addiction, exhibiting a synergistic effect. Attention should be paid to emotional issues and smartphone addiction among middle school students.
- Anxiety,
- Depression,
- Cellular phone,
- Behavior, addictive,
- Students

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References(28)

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