COVID-19 anxiety symptoms associated with problematic smartphone use severity in Chinese adults

J Affect Disord. 2020 Sep 1;274:576-582. doi: 10.1016/j.jad.2020.05.080. Epub 2020 May 27.


Background: COVID-19 is fast-spreading and potentially fatal, introducing home quarantine, social distancing, and increased internet usage globally. We investigated COVID-19 anxiety, general anxiety and depression symptoms, and their impact on problematic smartphone use (PSU) severity METHODS: Participants were 908 residents of a large Eastern Chinese city, surveyed from late-February to mid-March, 2020. We administered online measures including the Depression Anxiety Stress Scale-21, Smartphone Addiction Scale-Short Version, and items querying COVID-19-related news exposure and threat of death. Additionally, participants rated anxiety using the Generalized Anxiety Disorder Scale-7 with reference to COVID-19.

Results: COVID-19 anxiety correlated with severity of PSU, depression and anxiety. Using established cut-off scores, 12% of participants were identified with at least moderate depression, and 24% with moderate anxiety. Using structural equation modeling, COVID-19 anxiety related to PSU severity, mediating relations between general anxiety and PSU severity. However, controlling PSU for general anxiety and depression severity, COVID-19 anxiety no longer predicted PSU severity.

Limitations: Limitations include the cross-sectional research design and reliance on data from only one country.

Conclusions: Results are discussed in context of the I-PACE model of excessive internet use. While COVID-19 anxiety is likely a global anxiety-provoking event, other everyday worries and anxiety are additionally clinically important in driving excessive internet use.

Keywords: Anxiety; COVID-19; Depression; Pandemics; Smartphone addiction.

MeSH terms

  • Adult
  • Anxiety Disorders / epidemiology*
  • Anxiety Disorders / psychology
  • Behavior, Addictive / epidemiology*
  • Behavior, Addictive / psychology
  • Betacoronavirus*
  • COVID-19
  • Causality
  • China / epidemiology
  • Comorbidity
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / psychology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Pandemics
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / psychology
  • SARS-CoV-2
  • Severity of Illness Index
  • Smartphone / statistics & numerical data*
  • Surveys and Questionnaires