Introduction: Nomophobia means fear of running out of cell phone. Today, Nomophobia relates to the fear of running out of any digital resources.
Objective: To review literature on nomophobia from its earliest publications to the present day.
Method: Systematic literature review in the PubMed, Web of Science, PsycInfo, Portal CAPES, LILACS, COCHRANE databases, delimited to the period 2009 - 2019. After analysis of Titles, Abstract and Content, 30 manuscripts portrayed the three perspectives: (a ) evolution of the term nomophobia; (b) its consolidation as a Digital Dependency; (c) impacts on human behavior.
Results: A total of 572 articles were initially selected and included in study 30, all of them revealing evolution, characteristics of digital dependence and behavioral impacts.
Discussion: Surveys have evolved geographically from 3 countries (2009 - 2016) to 17 (2017 - 2019), with 7 new scales to measure nomophobia, 13 NMP-Q revalidations, and an increase from 1000 to 13000 volunteers, answering the questionnaires in these two periods. The 30 articles inserted confirmed Nomophobia as digital dependence for its analogous characteristics to other dependencies and shaped behavioral impacts on humans. Conclusions: Qualitative, quantitative and geographic evolution, as well as the increase in scale, samples and their new profiles were observed. New approaches reinforced evolution, its profile as a digital addiction and demonstrated their impacts. This study offers a historical perspective on Nomophobia and opens new perspectives on research, such as differences between countries, professions, sexes, allowing a deeper understanding of the subject.
nomophoba, digital dependence, smartphones, digital impacts, human behavior, digital technologies
Nomophobia stems from NO MOBILE PHOBIA (fear of running out of cell phone) created in the United Kingdom over the past decade and meant the fear of running out of cell phone due to loss, theft or phone connection issues. Today means fear of running out of access to cell phones, the Internet, social networking, messaging applications, which may represent extremely relevant developments in human dynamics including aspects related to psychological disorders associated with Nomophobia.
With the increased use of mobile phones, driven mainly by the mobility afforded by the fusion of the Internet with these mobile devices, the user population has increased exponentially providing a greater likelihood of nomophobic behavior. In addition to quantitative expansion, aspects of human behavior need to be investigated not only for their importance to people's quality of life, but also for possible influences on the collective environments in which they participate.
King, et al. [1] defined Nomophobia as a disorder of the modern world that could develop symptoms of anxiety, anxiety and nervousness caused by lack of access to cell phones, computers and other communication devices. In Brazil, in an unpublished Case Report King, et al. [2] presented the hypothesis of Nomophobia as digital dependence in an individual with Panic Disorder with Agoraphobia, relating cell phone dependence as an attenuator of the disorder.
Over the past decade, attention to nomophobic behavior has grown exponentially with research in countries like Iran, Italy, Spain, Portugal, India, Cina, Turkey among others, with differentiated approaches, using new measurement scales and analyzing new correlations Darvishi, et al. [3], Aguilerap-Manrique, et al. [4], Arpaci, et al. [5], Gutiérrez-Puertas, et al. [6]. Your investigation as Digital Pathological Addiction is necessary because symptoms such as discomfort, anxiety, anger or stress may emerge similarly in individuals with other types of addiction.
Bragazzi, et al. [7] demonstrated that individuals with high Nomophobia scores respond with stress and behavioral disengagement when confronted, revealing insights that require preventive and interventional measures in the population.
Argumosa-Villar, et al. [8] also reveal that Nomophobia impacts several areas of life, especially social, professional and academic relationships, due to the dependence on the use of smartphones. In the professional field, Oliveira, et al. [9] reported the presence of Nomophobia and its impacts on the organizational level.
The objective of this research was to review the literature on Nomophobia in the last ten years, from three perspectives: (a) the evolution of Nomophobia; (b) your belonging to the Digital Dependency; (c) impacts on human behavior.
This review was guided by the Preferred Reporting Items for Systematics Reviews and Meta-Analysis (PRISMA) while the keywords were searched at Medical Subject Headings (MeSH) where two were found (digital dependence and smartphones).
We used the PubMed, Web of Science, PsycInfo, Portal CAPES, LILACS and COCHRANE databases, in the English language, from October 2009 to October 2019, with the term Nomophobia, considering the three informed perspectives. The inserted articles are in Figure 1, allowing to identify the mentioned perspectives.
Figure 1. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
Selected 572 manuscripts. Examined Titles and deleted 308 manuscripts. The remaining (264 manuscripts) were reviewed for Abstracts. Deleted 148, leaving 116 eligible for reading, with elimination of 86 remaining 30 articles (Tables 1,2).
Table 1. Quantitative distribution of articles searched
The study was developed at the Delete Laboratory - Digital Detox and Conscious Use of Technologies, linked to the Institute of Psychiatry of the Federal University of the Rio de Janeiro (IPUB / UFRJ) that treats and guides individuals with evidence of excessive use of technologies that are compromised in personal, professional, social and academic life.
Evolution of the term Nomophobia
New countries are studying this phenomenon, showing geographic expansion and contributing to the increase of articles. New approaches have generated new Nomophobia measurement scales, as well as existing revalidations existing scale such as NMP-Q. Surveyed samples (2017–2019) add up 13,000 volunteers. Compared to 2009 - 2016, with 1100 volunteers, there was an average monthly growth of 4000%. The number of articles inserted for the period 2017-2019 was 23, which corresponds to 77% of the total number of articles inserted (30) in less time than the period 2009 - 2016.
Highlight for analyzes of gender-differentiated nomophobic behaviors Arpaci, et al. [10] as gender is considered statistically significant in terms of smartphone-derived habits Anshari, et al. [11].
Nomophobia as a Digital Dependency
All 30 articles address Nomophobia as a Digital Dependency, as a modern age phobia, introduced into our lives as a product of interaction between people and mobile information and communication technologies, especially smartphones [12].
Yildiz [13] reveals, in research with 612 students, that there is significant relationship between smartphones addiction and Nomophobia. They may have the same characteristics as long as they are associated with problematic cell phone use. Similar results on the relationship between smartphone use and Nomophobia were found in a survey of 409 students in Malaysia Parasuraman, et al. [14].
Trom [15] in a literature review of 117 manuscripts concluded that anxiety, depression and low self-esteem confirm characteristics of Nomophobia as digital dependence
Impacts on Human Behavior
All inserted articles indicate behavioral impacts by Nomophobia, in professional and social activities, in relation to primary disorders, resulting in new interpersonal relationships.
Bartwal, et al. [16] point out that Nomophobia is an emerging behavioral problem which needs attention. Increasing awareness regarding the harmful effects of smartphones addiction is needed. In a survey of 451 students, they found 303 with average Nomophobia rates.
Parasuraman, et al. [14] innovate by addressing Nomofobia under 8 segments: namely, informed consent form, demographic details, habituation, mobile phone fact and EMR - Electromagnetic Radiation Details, mobile phone awareness education, psycomotor (anxious behavior) analysis, with 409 students, when 78% showed nomophobic symptoms.
Yasan, et al. [17] verified 4 dimensions of Nomophobia as: not being able to communicate, losing connectedness, not being able to access information, giving up convenience, in a survey of 141 students who demonstrated adherence to at least two of these dimensions.
The increased use of new technologies and virtual communication involves personal computers, tablets and mobile phones causing changes in daily habits and individual behaviors King, et al. [13].
These habits are also in organizations and should be dealt with by Psychology and Psychiatry, given the requirements of companies that oblige the availability of employees at any time and place, so there is a need to take care of the health and well-being of their employees Oliveira, et al. [9].
The quantitative distribution of the researched articles (2009-2019) in the 6 academic bases and debugging until inserted articles (Tables 1-3).
Table 3. The following are 30 articles included
DD = Digital dependence; EFA = Exploratory Factorial Analysis; FA = Factorial Analysis; FoMOS = Fear of Missing Out Scale; HB=Human Behavior; HBI = Human Behavior Impact; IM = Idade Média; MP = Mobile Phone; NF = Nomophobia; NMP-Q = Nomophobia Questionnaire; SDF = Socio-Demographic Functions; SF=Smartphone.
Evolution of the Nomophobia Term
a) Geographic expansion
Nomophobia production evolved between 2009 and 2019, in two blocks: 2009 to 2016 (8 years) and 2017 to 2019 (less than 3 years). In the former, articles produced in the US, UK and Brazil prevail, while in the latter period (2017-2019) other countries emerged, such as Italy, Spain, Portugal, Kwait, India, Iran, Romania, China, Turkey, Hungary , Peru, Sweden, Israel, Hong Kong, meaning geographic evolution, revealing greater interest in Nomophobia.
This expansion is also located in comparative studies between students from different countries, such as Spain and Portugal, aiming to identify specificities between them Gutierrez, et al. [6] similar to what ocurred among students in United Kingdom, Romania and Hungary Csíbis, et al. [18].
Similarly Shin, et al. [19] compared the severe use of mobile Internet by Americans and Koreans, characterizing geographic expansion, and finding different dependent behaviors among them, in addition to significant differences between male and female outcomes, which also occurred in research in Brunei Anshari, et al. [11].
In Iran, Elyari, et al. [20] translated and validated the Yldirim & Correia Nomophobia Questionnaire - NMP-Q (2015) obtaining high reliability (Cronbach's Alpha = 0.983) corroborating results in Spain Gutierrez-Puertas, et al. [6], Italy Bragazzi, et al. [7] and India Basu, et al. [21]
b) Number of articles
From 2017 to 2019 were found 33% (188) of the articles indicated by the databases (572) meaning about 6 articles per month. From 2009 to 2016 were 67% (384), meaning 4 articles per month. In the final numbers of articles for qualitative analysis, 24 were produced from 2017 to 2019, meaning 0.8 article per month, while from 2009 to 2016, 0.04 article per month. Comparing these rates it is expressive growth of publications.
c) Increase in the number of Nomophobia Scales
There was scale growth, as well as renowned scale revalidations, in India Bartwal, et al. [16] and Iran Elyasi, et al. [20], where the Nomophobia Questionnaire - NMP-Q Yldirim, et al. [11] was appropriate to their respective cultures, strengthening the evolution of the theme and the scales themselves.
In China, with 966 smartphone users, the NMP-Q reported by Jianlig & Chang (2018) was revalidated with results similar to Spain Aguillera, et al. [4] and Italy Adawi, et al. [22].
Other validated scales have ratified Nomofobia's expansion, such as Scale for Problematic Mobile Phone Use - PU that measures overuse of mobile phones, correlation between mobile phone and mental variables and possibilities of negative effects of prolonged mobile phone use, in addition to the Fear of Missing Out Scale - FoMOS Coskun, et al. [23].
In a study by Arpaci, et al. [10] to identify the relationship between mindfulness and Nomophobia, another scale was used: the Nomophobia Questionnaire – NF, also used in USA with analogue results [17].
To identify Nomophobia symptoms (anxiety, compulsion and anxiety and panic) Rosales – Huamani, et al. [24] used the Test of Mobile Phone Dependence - TMD Brief confirming these symptoms of dependence on Nomophobia. This has been confirmed in Iran, for anxiety, using the NMP-Q (Darvishi et al, 2019).
In Spain, Argumosa-Villar, et al. [8] used the Mobile Phone Involvement Questionnaire (NMPIQ), finding a correlation between self-esteem, extroversion and awareness with emotional stability related to Nomophobia, innovating in treating Nomophobia related to psychological and not only demographic variables.
Csibis, et al. [18] used Smartphones Applications Based on Addiction Scale - SABAS, concluding that severity, anxiety and stress of depression are associated with problematic use of smartphones. In the same review, Csíbis et al. [18] also indicated for the evaluation of Nomophobia, the Smartphone Addiction Scale - Short Version - SAS - SV.
In India, Basu, et al. [21] developed and validated the Mobile Phone Addiction Scale (MPAS) with 388 medical students.
Besides the validation of new scales, others already used were revalidated in other languages as did Gutiérrez – Puertas, et al. with the NMP-Q.
Along the same lines, Al-Balhan, et al. [25] developed psychometric evaluation of the Arabic version of the NF Questionnaire (NF) in a pilot study at Kuwait University. This expansion also took place in 12 other countries between 2017 and 2019.
d) Sample Profiles / Target Audience
With the geographical expansion and need for adaptations and understanding of Nomophobia, new applications of measurement instruments in research have found different target audiences, such as doctors, nurses, students from different disciplines, public and private organizational managers, among others.
Quantitatively, it was observed that from 2017 - 2019 the sum of volunteers exceeded 13,000 versus just over 1,000 between 2009 and 2016, ratifying the significant increase of participants in Nomophobia research as a strong element of evolution.
e) Nomophobia between the sexes
Initially Nomophobia did not discuss results by gender. Between 2017 and 2019 the concern to assess prevalence by sex arises consistently.
Darvishi, et al. [3] investigated Nomophobia among students in Iran, seeking to identify feelings of anger, discomfort, anxiety and insecurity in the correlation of this phenomenon with age, gender, educational level and duration of smartphone use. Women feel less angry than men when they are without digital access and, consequently, less discomfort.
Anshari, et al. [11] had already concluded that sex is statistically significant in smartphone use, in a survey of 589 participants. Women make greater use of social networks, messaging and cell phones, with more marked misuse than men.
Arpaci, et al. [10] also identified greater impact on women in the relationship of mindfullness with Nomophobia.
Yldirim, et al. [12] found results that ratified that women are more susceptible to nomophobia than men, also identified in the US and Korea by the greater dependence of women on men [19].
Different reactions between male and female outcomes provide a new perspective for Nomophobia analysis.
Nomophobia as a Digital Dependency
The definitions between Nomophobia and Digital Dependence converge significantly because according to King, et al. [1] Nomophobia refers to the feelings of discomfort or anxiety experienced by individuals when they are unable to use their mobile phones or use affordances these devices provide. Patologic Digital Dependence is when running out of digital devices bring symptoms of nomophobia such as anxiety, discomfort, panic, among others.
Lin, et al. [26] found that problematic cell phone use has increased markedly over the past five years and is related to the phobia of being without them (nomophobia).
a) In professional activities
The use of mobile phones simultaneously with work activities may compromise performance activities.
Aguilera-Manrique, et al. [4] identified nursing students in Spain using smartphones during internship activities, revealing a statistically positive relationship between Nomophobia and smartphone-associated distraction.
Oliveira, et al. [27] report that Nomophobia can reveal itself in organizations due to the demands of employee availability at all times, wherever they may be.
b) Social commitment
Nomophobia is an emerging social behavioral problem that needs attention because of its varying degrees of severity, with impairment due to cell phone dependence [16].
Trom, et al. [15] classifies Nomophobia as a disorder and states that compulsive smartphone use causes significant impairment of social, physical and cognitive functions.
Nomophobia affects different areas, especially social, professional and academic relationships, due to the dependence on smartphone use Argumosa-Villar, et al. [8].
Fitz, et al. [28] approached smartphone well-being in research, showing anxiety and FoMO - Fear of Missing Out, when participants received no notifications, affecting social behavior, while those receiving them regularly felt more productive and satisfied.
c) Relationship with primary disorders
The relationship between anxiety and stress of depression has been demonstrated in a systematic review, concluding by the relationship with Nomophobia [18].
King, et al. [1] refer to Nomophobia as a feeling of discomfort or anxiety experienced by individuals when unable to use cell phones or use their facilities.
People with panic disorder showed significant increases in anxiety, tachycardia, respiratory changes, tremors, sweating, panic, fear and depression, relative to the lack of their cell phones King, et al. [29].
Rosales-Huamani, et al. [24] using the TDM Brief Test of Mobile Phone Dependence with 461 students confirmed symptoms related to Nomophobia: (a) anxiety; (b) compulsive use of smartphones; (c) feeling of anxiety and panic.
Increased anxiety besides irritability when not in contact with the digital device were symptoms identified by Adawi, et al. [22] characterizing Nomophobia as technological dependence.
However, according to Csíbis, et al., an inverse relationship between depression and excessive smartphone use is possible. In this case, the emptiness of depression would be partially or temporarily supplied by digital attractions.
Due to its amplitude and relationship with anxiety, depression and low self-esteem, Trom, et al. classifies Nomophobia as smartphone dependence, proposing inclusion in the DSM - Diagnostic and Statistical Manual of Mental Disorder.
d) Transformation of interpersonal relationships
The transformation of individuals through digital practices and the manifestation of Nomophobia also alters interpersonal relationships.
Digital technologies can change the way we form relationships, with positive and negative effects, depending on how we use or abuse them.
Olivencia-Carrión, et al. [27] showed that cooperation significantly reduces nomophobic levels, with a relationship between nomophobia and personality.
There are many manuscripts published that discuss Nomophobia, but it was necessary to select them according to the delimitation defined in this review, mainly the three selected perspectives: (a) evolution of the term nomophobia; (b) its consolidation as a Digital Dependency; (c) impacts on human behavior. Another limitation is the novelty of the Nomophobia theme, which, on the other hand, becomes a new opportunity for researchers.
Results showed geographical evolution of Nomophobia, evolving from 3 countries (2009 - 2016) to 17 countries (2017 - 2019) with consistent research results, registering an increase of about 20 times more articles between the two periods, substantial increase of 7 news scales and 13 validations of NMP-Q in several countries (Table 3). New sample profiles and analysis of differences between men and women drew attention to the need to assess this difference about nomophobic behaviors between the two sexes. The study demonstrates that Nomophobia is Digital Dependence, due to its pathological characteristics. In all inserted articles the impact of the Nomophobia on professional and social activities presenting significant relationships with primary psychological disorders, redesigning interpersonal relationships, was reported. These results confirm the achievement of the research objectives.
Gonçalves prepared the literature review and wrote the article; Nardi supervised and guided the preparation of the text. Bortolanza and Pádua realizaram pesquisas; King supervised the literature review and the final form of the text. All authors contributed and approved the final version.
Institute of Psychiatry (IPUB) of the Federal University of Rio de Janeiro (UFRJ).
This study was not funded.
All of authors declare that has no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
- King ALS, Valença AM, Silva ACO, Baczynki T, Carvalho MR, et al. (2013) Nomophobia: dependency on virtual enviroments or social Phobia? Computer in Human Behavior 29: 140-144.
- King ALS, Valença AM, Nardi AE (2010) Nomophobia: The Mobile Phone in Panic Disorder with Agoraphobia. Reducing Phobias or Worsening of Dependence? Cogn Behav Neurol 23: 52-54. [Crossref]
- Darvishi M, Noori M, Nazer MR, Shakhleshan S, Karimu E (2019) Investigating differents dimensions of Nomophobia among medical students: A Cross-sectional Study. Open Access Maced J Med Sci 7: 573-578. [Crossref]
- Aguilera-Manrique G, Márquez-Hernandez VV, Alcarez-Córdoba T, Granados-Gáriz G, Gulceuz-Puertas V, et al. (2018) The relation between Nomophobia and the distribution associated use of smartphone between nursing studentes in your clinical stage..
- Arpaci I, Baloglu M, Kogan H, Kesici S (2019) A multi-group analysis of the effects of individual differences in mindfulness on Nomophobia. Journal Indexing & Metrics 35.
- Guttierrez-Puertas L, Marquez-Hernandez VV, São-Romão-Preto L, Granados-Gámez G, Gutierrez-Puertas V, et al. (2019) Comparative Study of Nomophobia among Spanish and Portuguese nursing students. Computer Information Nursing 34: 470-475.
- Bragazzi NL, Re TS, Zerbetto R (2019) The Relationship Between Nomophobia and Maladaptive Coping Styles in a Sample of Italian Young Adults: Insights and Implications From Cross-Sectional Study. JMIR Ment Health 6: e13154. [Crossref]
- Argumosa-Villar L, Boada-Grau J, Virgil-Colet A (2017) Exploratory investigation of theoretical predictors of Nomophobia using Mobile Phone Involvement Questionnaire (MPIQ) . J Adolesc 56: 127-135. [Crossref]
- Oliveira TS, Barreto LKS, El-Aonar WA, Souza LA, Pinheiro VLS (2017) Where`s my cell phone? Analysis of nomophobia in the organizational enviroment, ERA – Revista de Administração de Empresas 57: 634-635.
- Arpaci I, Baloglu M, Kogan H, Kesici S (2017) Individual differences in the relationships berween attachment and nomophobia among college studentes: the mediating role of mindfulness. J Med Internet Res 19: e404. [Crossref]
- Anshari M, Alas Y, Hardaker G, Jaidin JH, Smith M, et al. (2016) Smartphone habit and behavior in Brunei: personalization, gender and generation gap. Computer Human Behavior 64: 719-727.
- Yldirim C, Correia AP (2015) Exploring the dimensions of Nomophobia: Development e validation of a self-reported questionnaire. Computers in Human Behavior 4: 130-137
- Yildiz DH (2018) Investigation of Nomophobia and Smartphone addiction predictors among adolescents in Turkey: Demographic Variables and academic performance. The Social Science Journal 56: 492-517.
- Parasuraman S, Sam AT, Yee SWK, Chuon BLC, Ren LY (2017) Smatphone Usage and incresead risk of mobile phine addiction: A concurrent study. Int J Pharm Investig 7: 125-131. [Crossref]
- Trom D (2016) Classifying Nomophobia as Smartphone Addicition Disorder. UC Mercer Undergraduate Research Journal 9.
- Bartwal J, Nath B (2019) Evaluation of Nomophobia among medical students using smartphones in north India. Medical Journal Armed Forces of India 76: 451-455.
- Yasan AK, Yildirim S (2018) Nomophobia among undergraduate students: The Case of a Turkish State University. International Journal on New Trends in Education and Their Implications 9: 11.
- Csíbi S, Griffiths MD, Cook B, Dimetrovics Z, Szabo A (2018) The psychometrics properties of the smartphone: Applications Based Addicition Scale (SABAS). Int J Ment Health Addict 16: 393-403. [Crossref]
- Shin L (2014) A Comparative Study of Mobile Internet Usage between the USA and Korea. Journal of European Psychiatry Students 5: 46-55.
- Elyasi F, Hakini B, Islami-Parkoohi P (2018) The Validity and Reliability of the Persian Version of Nomophobia Questionnaire. Addict Health 10: 231-241. [Crossref]
- Basu S, Garg S, Singh MM, Kohlic C (2018) Addiction-like Behavior Associated with Mobile Phones Usage Among Medical Students in Delhi. Indian J Psychol Med 40: 446-451. [Crossref]
- Adawi M, Zerbetto R, Bisharat B, Mohamed M, Amital H, et al. (2019) Psychology Research and Behavior Managemnet 12: 145-154.
- Coskun S, Karayagiz MG (2019) Investigation of Problematic Mobile Phones use (PU) and Fear of Missing Out (FoMO) level in Adolescentes. Community Ment Health J 55: 1004-1014. [Crossref]
- Rosales-Huamani JÁ, Guzman-Lopez RR, Aroni-Vilca EE, Matos-Avalos CR, Castilo-Sequera JC (2019) Determining Symtomatic Factors of Nomophobia In Peruvian Students from the National University of Engennering.
- Al- Balhan EM, Khaboche H, Watfa A, Sinona Re T, Zerbetto R, et al. (2018) Psychometric Evaluation of the Arabic version of the NF Questionnaire: Confirmatory and Exploratory FA – implications from a pilot study in Kuwait among university students. Psychology Res Behavior Manag 11: 471-482. [Crossref]
- Lin C, Griffiths MD, Pakpour AH (2018) Psychometric evaluation of Persian NF Questionnaire (NMP-Q). J Behav Addict 7: 100-108. [Crossref]
- Olivencia-Carrion Ma, Ferri-Garcia R, Rueda MDM, Jimenez-Torres MG, Lopez-Torrecilla F (2018) Temperament and Characteristics related to Nomophobia. Psychiatry Research 266: 5-10.
- Fitz N, Kushlev K, Jagannathan R, Lewis T, Paliwal D, et al. (2019) Batching smartphone notifications can improve well-being. Computer Human Behavior 1010: 84-94.
- King ALS, Valença AM, Silva AC, Sancassian F, Macedo S, et al. (2014) Nomophobia: Impactof cell phone use interference with symptoms and emotion of individuals with panic disorder comparde with a contol group. Clin Pract Epidemiol Ment Health 10: 28-35. [Crossref]
