NOMOPHOBIA

The effect of emotional regulation strategies

Mirna Cheiban - 2nd year psychology intern

Outline
1. Learning Objectives
2. Introduction to Nomophobia
3. Theoretical Frameworks behind Nomophobia
4. Emotional regulation and its role in Nomophobia
5. Treatment Approaches for Nomophobia
6. References
1. Learning Objectives
1. Define nomophobia and identify its key symptoms and behaviors.

2. Explain the psychological and addiction theories that underlie

nomophobia, including the concepts of technology dependency.

3. Analyze the role of emotional regulation in the development and

maintenance of nomophobia

4. Discuss treatment approaches for nomophobia, both at the individual

level (e.g., therapy and habit change) and the systematic level (e.g., policy
and design changes).
 NO MObile PHone PhoBIA
is an emerging concept closely tied to technological advances, referring to
the irrational anxiety or fear that regular mobile phone users exhibit when
their phone is not immediately available due to the fear of missing
messages or being unable to contact others

was coined by the United Kingdom (UK) Post Office in 2008 during a study
who commissioned YouGov, a UK‐based research organization. The
objective of that study was to evaluate the possibility of anxiety disorders
occurred due to overuse of mobile phones.

It is a modern phobia of the digital age, and is related to the

problematic use of mobile technologies and addiction problems
So, what is the difference?
 So, what is the difference?
Nomophobia and smartphone addiction differ mainly in the way a
smartphone user behaves with their smartphones.

A smartphone user experiences nomophobia when fear or anxiety over not

using a smartphone occurs (Bian & Leung, 2015;Emanuel et al., 2015
;SecurEnvoy, 2012; Yildirim, 2014).

On the other hand, a smartphone user suffers from smartphone addiction

when he or she excessively uses a smartphone regardless of harmful
consequences (Bian & Leung, 2015).
What is the relationship between nomophobia
and smart phone addiction?
Yildirim (2014) Tran (2016)
-has noted that, even though -has argued that nomophobia should
nomophobia can lead to be regarded as not only a specific
smartphone addiction, it should phobia but also a withdrawal
not be treated as an addiction symptom of smartphone addiction.
because nomophobia is a
situational phobia. -has asserted that nomophobia and
smartphone addiction cannot be
considered as unrelated disorders
because they share the same
symptoms and similar comorbid
disorders such as social phobia,
obsessive-compulsive disorder, and
depression.

Thus, nomophobia and smartphone addiction can be

considered to be two closely related conditions.
 Nomophobia Smartphone
addiction
-due to constant desire to
be with the smartphone

Smartphone Nomophobia
addiction
-uncontrollable excessive
smartphone use that when the
smartphone is away, a feeling of
fear or anxiety takes over.

The cycle
goes on
Characteristics and Symptoms of Nomophobia
The 7 Characteristics of Nomophobia
1. Using one’s smartphone for long durations of time
2. Constantly carrying one’s phone charger
3. Feeling deeply concerned about the possibility of losing one’s smartphone
and losing network coverage.
4. Calling others or checking messages frequently
5. Being unable to switch off one’s smartphone for 24 h
6. Communicating using new technologies that limit face-to-face social
interactions
7. Witnessing an increase in the costs and debts associated with smartphone
use
Signs and symptoms are observed in Nomophobia cases
• Anxiety
• Respiratory alterations
• Trembling
• Perspiration
• Agitation
• Disorientation • Tachycardia
3. Theoretical Frameworks behind Nomophobia
Gratification Social learning Attachment Theory
Theory Theory individuals form emotional
people actively seek out behaviors are learned bonds not only with people
media to satisfy various through observing others but also with objects,
needs, such as the need for and imitating their especially those that provide
information, social actions. In a world where a sense of security or
interaction, or entertainment. mobile phone use is emotional support.
Phones provide instant pervasive, the behavior Smartphones have become
gratification in multiple is modeled as both such objects, functioning as
ways, including instant normal and necessary constant sources of
messaging, social media, for functioning in information, entertainment,
entertainment, and modern society. social connection, and
work-related tasks. security.

Type of seperation
psychological dependency
Type of seperation
peer pressure reinforcement
anxiety is a type of seperation anxiety
anxiety

1. Psychological
and social
theories
Theoretical Frameworks behind Nomophobia
Digital Addiction Continuous partial attention
model (CPA)
Mobile phones are not only Linda Stone describes a modern
tools, they are designed to behavior where individuals
be addictive constantly scan and monitor
multiple sources of information,
https://www.youtube.com/wat without fully focusing on any one of
ch?v=NUMa0QkPzns them.The focus is on always being
"on alert" for new information,
updates, or stimuli, which keeps
start at 0:35
people in a state of hyper-vigilance
but doesn't allow for deep focus or
meaningful engagement.

is a consequence of is a consequence of
systems and fear of missing out+
persuasive design 2. Technology thinking our brain is
dependence and limitless
addiction models
Theoretical Frameworks behind Nomophobia
GAD, panic disorder and Emotional Regulation and
social anxiety Coping Mechanisms

Phones can be used as a way to

Nomophobia arises when regulate emotions. Nomophobia can
individuals fear they will be develop when individuals lose their
unable to manage this primary coping mechanism (the
anxiety without their phone. phone), leading to heightened
anxiety and an inability to manage
emotions effectively without it.

3.
3. Models
Models linked
linked
to
to Mental
Mental Health
Health
Theoretical Frameworks behind Nomophobia

Digital Addiction Emotional Regulation and

Coping Mechanisms

Nomophobia
4. Emotional regulation and Nomophobia
 Introduction
Human beings are social creatures. Previously, we used to do a lot of face to face social
interaction. Due to rapid urbanization, migration and increasing numbers of nuclear families,
disintegration of social fabric has taken place in our society leading to a vacuum kind of situation.
Mobile phones have effectively filled this vacuum, e.g., with the help of social media through
which we are connected with others, nearly all the time.

impaired social functioning

insomnia
musculoskeletal injuries
depression

can trigger nomophobia

mobile phone addiction
compulsive internet use
behavioral disorders
 Introduction

compulsive internet use difficulties in emotional

regulation

Which population is most affected by this?

Teenagers University students Women

 Which population is most affected by this?
A 2023 systematic review summarising 23 papers
from 8 countries (USA, Lebanon, Netherlands, Italy,
Japan, Spain, Phillipines and South Korea) with
approximately 11,300 participants showed that the
highest nomophobia prevalence occurred in the
university students population (97.38 %), among
other groups, including the general adults,
University students community adolescents and high school students.

A survey showed that 56.8 ,% 24.5 %, and

18.2 % of pharmacy students had mild,
moderate, and severe nomophobia.
Nomophobia affects academic performance,
especially in medical students.
Accordingly, it is important to identify the
risk and protective factors of nomophobia
in college students to help parents, schools,
and society take reasonable measures to
ensure young adulthood mental health.
 Why is emotion regulation becoming more important ?

During and after the COVID19- outbreak, negative

emotions such as loneliness, depression, and
anxiety are becoming more prevalent and attracting
attention from researchers

1. Poor emotion regulation predicts all

addictive behaviors, including problematic
mobile phone use, video game addiction, and
gambling disorder.

2. People with mobile phone addiction are

more likely to exhibit more difficulties in
emotion regulation.
 Emotion Processing Model of Negative reinforcment

The addicts’ inability to manage negative emotions

associated with addiction leads to the maintenance of
addiction. Researchers have also suggested that
individuals’ inadequacy in regulating negative emotions
leads to mobile phone addiction

Previous studies on the effects of nomophobia on college students’

mental health have focused on personality traits, impulsivity sleep
quality and perceived stress.

This research will explore the relationship between emotional regulation

and nomophobia
 Emotional Regulation
is the adaptive monitoring, evaluation and response to emotions

Cognitive Reappraisal Expressive Suppression

involves adjusting the perception of is a reactive strategy which involves
situation to decrease their emotional suppression emotions and their
impact, potentially averting negative outward expressions, resulting in
emotions, or lessoning their intensity heightened internalized negative
emotions

“When I want to feel less negative “I keep emotions to myself”

emotion, I change the way I’m
thinking about the situation”

may alleviate nomophobia symptoms adds to behavioral disorders

H1a: Cognitive reappraisal negatively predicts nomophobia

H1b: Expression suppression positively predicts nomophobia.
 Another important factor in young adulthood: Resilience
the ability to withstand high levels of disruptive change

Emotional regulation is an important element

Researches have shown that resilience is positively associated with positive
reappraisal. In contrast, resilience was negatively associated with expressive
suppression.

Greater resilience was found to be associated with lower mood disturbances,

greater use of cognitive reappraisal, and less use of expressive suppression
strategies
 Resilience and nomophobia
When experiencing stress, resilience acts as a protective factor and reduces
psychological distress. Resilience is significantly and negatively associated
with substance abuse and behavioral disorders.
However, the relationship between resilience and nomophobia remains
unclear.

H2c: Psychological resilience negatively predicts nomophobia

Higher psychological resilience is associated with better positive coping

styles. Thus, resilience may act as a protective factor mediating the effects of
cognitive reappraisal and/or expressive suppression on nomophobia.
Research Hypotheses
2. Methods
Participants
-Participants were invited from a university in northeastern China via its
college student mental health guidance center.

-From March to May 2023, a recruitment notice was issued and online
questionnaires were distributed to the volunteers using WeChat

-A total of 856 students completed the questionnaires.

-Finally, the investigators carefully checked the recovered questionnaires

and determined that 756 ones were included in the final analysis
according to the inclusion and exclusion criteria.

-The inclusion criteria were college students older than 18 who

volunteered to participate in the survey and used smartphones.

-When the lie-detecting items were answered improperly (n = 97), or the

self-reported age was unreliable (n = 3), the questionnaires were regarded
as ineffective. The effective recovery rate of the questionnaires was
88.3 %
2. Methods
Participants

aged between 18 and 28 years, with a mean age of 19.77 and an SD of

1.6 years
2. Methods
Participants

mobile phone use profiles

2. Methods
Scales

Variable Questionnaire Items Scores Dimensions

Z-score below − ≤ ,1 Inability to access info (0.873)
1. Severity of Nomophobia 18 items, 7 1 − to the mean, ≥
Nomophobia questionnaire point Likert mean to 2, and Abandonment of convenience (0.876)
Symptoms (NMP-Q), 2015 Scale greater than 2
Inability to communicate (0.931)
α = 0.955 indicated absent,
low, medium, severe,
Loss of connection (0.932)
and extremely severe

Emotion Higher scores

2. Emotional 10 items, 7 indicated that Cognitive reappraisal (0.894)
regulation regulation point Likert students used
strategies questionnaire Scale corresponding
(ERQ), 2003 emotion regulation Expressive Suppression (0.830)
α = 0.845 strategies

3. Resilience The resilience 14 items, 7 RS14- scores of ≤,63

levels 64 - 73 and ≥74 Individual ability (0.943)
scale (RS14) point Likert
2009 indicated that
Scale students had lower,
α = 0.947
moderate, and higher
psychological Acceptance of self and life (0.846)
resilience,
respectively.
2. Methods
NMP-Q
2. Methods

ERQ
2. Methods
RS- 14
3. Results

Women had higher NMP-Q total scores than men. Women scored higher than men on all dimensions
of the NMP-Q. Nursing and medical technology students had higher NMP-Q scores than other
medical majors. Longer duration of mobile phone use was associated with more severe nomophobia.
 3. Results

Regarding emotion regulation strategies, women used cognitive reappraisal strategies more
frequently (men: M = 29.39, SD = 7.30; women: M = 30.57, SD = 5.67; t(2.21- = (756, p = 0.03). Men
used expressive suppression strategies more frequently (men: M = 16.60, SD = 5.31; women: M =
15.4, SD = 4.82; t(2.76 = (756, p = 0.01). There was no difference in resilience between men and
women (p = 0.72).

Correlation analysis between various variables

There is a significant positive correlation between nomophobia and use of cognitive reappraisal
(r = 0.15, p < 0.01) and expressive suppression (r = 0.29, p < 0.01).
 3. Results

-For cognitive reappraisal, cognitive reappraisal positively predicted nomophobia (β = 0.54, p <
0.001) in the first step.
-In the second step, cognitive reappraisal also positively predicted resilience (β = 1.29, p < 0.001).
-In the third step, cognitive reappraisal positively predicted nomophobia (β = 0.80, p < 0.001), while
resilience had an significant negative impact on nomophobia (β = − 0.20, p < 0.01).
-This indicates that resilience had a significant masking effect between cognitive reappraisal and
nomophobia.

- Similarly, in the fourth step, expressive suppression positively predicted nomophobia (β = 1.42, p <
0.001).
-In the fifth step, expressive suppression was found not significantly associated with resilience (p >
0.05).
-In the sixth step, expressive suppression positively predicted nomophobia (β = 1.43, p < 0.001),
while resilience had an insignificant negative impact on nomophobia (p > 0.05).
 3. Results

The bootstrap technique was used to examine the mediating role of resilience in the model.

The value of the total effect of cognitive reappraisal on nomophobia was 0.54, with a confidence interval
of [0.80 ,0.28]. The direct effect value was 0.80, with a confidence interval of [1.11 ,0.48].

The indirect effect of resilience in the relationship between cognitive reappraisal and nomophobia was −
0.26, with a confidence interval of [− 0.05 − ,0.47], excluding the value of 0.

This further indicates that resilience mediates the relationship between cognitive reappraisal and
nomophobia.
 3. Results

The conclusion is drawn that this is a masking effect (ab/c = 32.5 %), because the indirect effect
and the direct effect have opposite signs.

-Similarly, the value of the total effect of expressive suppression on nomophobia was 1.42, with a
confidence interval of [1.73 ,1.12]. The direct effect value was 1.43, with a confidence interval of [,1.12
1.74]. The indirect effect of resilience on the association between expressive suppression and
nomophobia was 0.00, with a confidence interval of [− 0.02 ,0.02], including 0.

Thus, expressive suppression directly predicts nomophobia without the mediating role of
resilience. Therefore, Hypothesis H3a, but not H3b, is supported.

H3a: Psychological resilience will negatively mediate the relationship between cognitive
reappraisal and nomophobia
H3b: Psychological resilience negatively mediates the relationship between expressive
suppression and nomophobia.
3. Results
 4. Discussion
Prevalence of nomophobia
The results of this study showed that 85.60 % of Chinese university students suffered from varying levels
of nomophobia symptoms, indicating a high prevalence. This is comparable to the prevalence rates
reported in other countries. A study in Lebanon (2021) showed that 1089 participants (48.3 %) had
moderate nomophobia, while 349 participants (15 %) had severe nomophobia.

Age and nomophobia

No age differences were found in nomophobia in the sample. Some previous studies have also shown
that the prevalence of nomophobia is not related to age. People of all ages widely use mobile phones,
and they are necessary for study, work, entertainment, hospital visits, travel, and so forth. However,
other studies have shown a negative correlation between age and nomophobia, with older students
scoring lower on nomophobia since younger people are more familiar with online technology. A larger
sample size is warranted in order to verify the relationship between these two variables.

Gender and nomophobia

This study observed that women scored higher on nomophobia than men. This difference may be
related different leisure style between genders. Women prefer to use their phones to socialize and stay
connected with their friends during their free time, while men prefer outdoor sports to mobile phones to
kill time.

Longer mobile phone use

The findings suggest that longer daily mobile phone use was significantly associated with nomophobia.
In line with this finding, a bidirectional relationship between nomophobia and duration of daily mobile
phone use was also seen previously
 4. Discussion
Emotion regulation, resilience and nomophobia
The results of this study showed that the severity of nomophobia was significantly positively associated
with the use of emotion regulation strategies, including cognitive reappraisal and expressive
suppression, and significantly negatively associated with resilience.

Cognitive reappraisal as an adaptive emotion regulation strategy also positively predicted

nomophobia, which was surprising. This finding suggests that university students, regardless of the
emotion regulation strategy used, regulate their emotions by seeking help from their mobile phones
when encountering difficulties. This may depend on environmental changes and individual coping
preferences, as well as the fact that cognitive reappraisal strategies rationalise mobile phone use and
lead to addiction.

Expressive Suppression Although people with high resilience tend to choose adaptive emotion
regulation strategies, expressive suppression seems not always maladaptive. Some scholars have
suggested that expressive suppression plays a relatively positive role in collectivist cultures.
Specifically, the social goal of a collectivist culture is interpersonal harmony, and this emotion
management strategy effectively promotes interpersonal harmony. Therefore, Asians prefer to
expressive suppression.

Expressive inhibition strategies are used more often to avoid conflicts, According to the recently
proposed framework for emotion regulation, they promote the development of resilience as long as
appropriate emotion regulation strategies are used to regulate emotions.A research investigated 71
European and American students from Hong Kong and 100 Chinese students and showed that
expressive suppression was associated with poor psychological functioning in Europe and the United
States but not in Chinese participants.
 4. Discussion
Emotion regulation, resilience and nomophobia
A previous study has shown that the correlation between expressive suppression and negative mental
health indicators was stronger in the Western cultural values than in the Eastern cultural values. In
contrast, no similar cultural differences were found in studies on cognitive reappraisal.

Therefore, moderating variables such as cultural differences should be considered in the

follow-up investigation regarding the relationship between emotional regulation and mental
health.

Resilience negatively mediated the relationship between cognitive reappraisal and nomophobia and
attenuated the effect of cognitive reappraisal on nomophobia, suggesting that resilience is a potential
protective factor. Increasing resilience might be a promising regimen to alleviate nomophobia
symptoms caused by emotion dysregulation.

In this study, resilience did not mediate the effect of expressive suppression on nomophobia. We thus
reckon that loneliness might be the potential mediator, as a previous research has shown expressive
suppression may lead to increased loneliness. This assumption needs further confirmation.

Limitations
-Study was cross-sectional; therefore, obtaining a clear causal relationship between the major variables
was difficult.
-All data were self-reported, which could have caused information bias.
-Although many control variables were included in this study, additional confounding variables should
be considered in future studies to better understand the complicated relationships between the study
variables. These variables include personality, family background, academic pressure, and social
initiative.
 Treatment Approaches for Nomophobia - Role of health promotion

Level 5 Rehab

Mental Health
Services Psychosocial
Level 4 services

Medical treatment of acute health

problems and treating symptoms
Level 3

Prevention of Nomophobia
Comunity and
Policies Level 2

Policy and Law, Education,

Level 1 Encouraging social activities
 Level 1 - Policy and Law, Values, Education, Encouraging social activities

There is no limit to how many mobile phones a person can use. Some
people own and use multiple phones, which makes nomophobia worse.
Policy and Law It is suggested that Telecom Regulatory Authorities should take action by
creating rules or a law that limits how people use phones. One idea is to
have be a minimum age for phone use

Parents must have awareness regarding nomophobia. School authorities

should appoint counsellor and health team personnel for educating and
Education dealing with such incidences.
In many schools/colleges mobile phone restriction is strictly enforced.

Local governments can organize community engagement

1. Decreasing cost of entry to social activities
Encouraging social 2. Keeping accessibility as a priority (hybrid of online and offline)
activities 3. Creating content to capture attention
4. Sparking meaningful conversations
5. Reflect on community engagement strategy ( and feedback)
6.Closing loops
Level 2 - Prevention of Nomophobia
Identification of nomophobia can be identified in school settings or the workspace via a
settings-based approach, without the need of surveys or questionnaires.
Then, they can be reffered by a supervisor to seek on-site counseling.

Level 3 - Medical treatment of symptoms

Presently, the treatment modalities are very limited due to the disease concept is relatively new.

However, treatment modalities like cognitive‐behavior therapy, combined with

pharmacological interventions shows promising results. Tranylcypromine and Clonazepam
drugs are becoming quite successful in treating nomophobia signs and symptoms.

Therapy options
CBT Reality Therapy

-reinforces the autonomous behavior In this therapy the patient is advised to

which is independent from focus on behaviors (gardening, painting,
techno‐addictions. playing, etc.) other than using mobile
phones.
-Not approved by RCTs for nomophobia

We have to keep in our mind that nomophobia should be diagnosed by exclusion and for that
we have to investigate very cautiously, identify and treat any underlying pre‐existing mental
disorders, if any.
References

Buctot, D. B., Kim, N., & Kim, S. H. (2020). The role of nomophobia and smartphone addiction
in the lifestyle profiles of junior and senior high school students in the Philippines. Social
Sciences & Humanities Open, 100035 ,(1)2. https://doi.org/10.1016/j.ssaho.2020.100035

Bhattacharya, S., Bashar, M. A., Srivastava, A., & Singh, A. (2019). NOMOPHOBIA: NO MObile
PHone PhoBIA. Journal of family medicine and primary care, 1300–1297 ,(4)8.
https://doi.org/10.4103/jfmpc.jfmpc_19_71

Cui, M., Wang, S., Gao, Y., Hao, Y., & Dai, H. (2024). The effect of emotion regulation strategies
on nomophobia in college students: The masking role of resilience. Heliyon, (9), e30075.
https://doi.org/10.1016/j.heliyon.2024.e30075

Thank you!