The relationship between mental health and smartphone over dependence among multicultural adolescents and general adolescents

Kyung-Shin Paek*

Department of Nursing, Semyung University, Jecheon-City, Chungbuk, 27136, Korea

*Corresponding Author:
Kyung -Shin Paek
Department of Nursing, Semyung University, Jecheon-City, Chungbuk, 27136, Korea
Tel: +821045861618
E-mail: [email protected]

Received Date: September 30, 2021; Accepted Date: October 20, 2021; Published Date: October 27, 2021

 
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Abstract

Purpose: Multicultural adolescents are increasing every year in Korea, and multicultural adolescents have many difficulties compared to general adolescents because their parents have different cultural backgrounds. In particular, adolescents are highly dependent on smartphones, which negatively affects their mental health. This study was to identify the correlation between stress awareness, depression experience, generalized anxiety disorder, and smartphone overdependence of multicultural adolescents and general adolescents.

Method: Data from the 16th online survey of youth health behavior (2020) was used to analyze 39,987 adolescents. The data were analyzed using complex sample analysis by using SPSS/Win 22.0

Results: There was no significant difference in stress awareness, depression, generalized anxiety disorder, and smartphone overdependence between multicultural and general adolescents.

Multicultural adolescents showed significantly higher control failure of smartphone overdependence.

The use time of smartphones on weekdays and weekends was significantly higher in multicultural youth. In both multicultural and general adolescents, smartphone overdependence was higher in the middle-level academic achievement and the higher the stress awareness and generalized anxiety disorder, the higher the possibility of smartphone overdependence. The smartphone overdependence of general youth was significantly related to gender, age, school level, residence type, and depression.

Conclusion: To prevent adolescents€™ overdependence on smartphones, it needs to differentiate approaches according to the characteristics of multicultural and general adolescents.

Keywords

Stress; Depression; Anxiety; Smartphone; Overdependence; Adolescents

Introduction

Smartphones have the advantage of being able to use necessary information conveniently without being restricted between time and time, but they also make side effects of overdependence on the smartphone due to addictive use. Smartphone overdependence means that smartphone use becomes the most important activity in everyday life (salience), and it is difficult to control the degree of smartphone use by oneself (self-control failure), conflict with people around it, physical discomfort, and difficulties in the home, school, and workplace life (serious results) [1].

Excessive use of smartphones causes mental and social health problems such as stress, depression, anxiety, attention deficit, hyperactivity, interpersonal relationship, communication, and maladjustment to school life as well as physical health problems such as eye fatigue, dry eye syndrome, and musculoskeletal pain [2].

According to the survey on the status of smartphone overdependence in 2019 [1], adolescents' smartphone overdependence increased by 30.2% (high-risk group 3.8%, potential risk group 26.4%) compared to the previous year, and it was the highest among all age groups, adolescents are vulnerable to smartphone overdependence.

On the other hand, the total number of students and the school-age population in Korea is decreasing, while the number of multicultural students has increased by more than 10,000 every year for the past six years. Multicultural adolescents face many difficulties due to their different cultural backgrounds. It is difficult to form a bond due to difficulties in communicating with parents, and in schools, it is often difficult to form a smooth relationship with peers due to difficulties in language and school life adaptation. In addition, multicultural youth families are often lower in economic level than ordinary families, so parents often work double-income, so children tend to be neglected after school [3-5]. Therefore, multicultural adolescents are likely to be isolated from schools and families, which will spend a lot of time using smartphones, leading to smartphone overdependence [6].

Most of the studies on smartphone overdependence were conducted for general adolescents, and various variables such as stress [6], depression [2], impulsiveness, anxiety [7], interpersonal relationship, self-esteem [8], and school violence [9] are reported to be related to smartphone overdependence.

Unlike general adolescents, multicultural adolescents have high acculturation stress due to different cultural backgrounds of their parents [10], higher depression experience, and suicidal ideation rate than general adolescents [11, 12], and are reported to be excessively immersed in computer use such as internet games [13].

Therefore, the overdependence of the smartphones of multicultural youths is different from that of ordinary youths. However, there are not many studies comparing the differences between multicultural and general adolescents in terms of smartphone overdependence [12].

The purpose of this study is to compare mental health such as stress recognition, depression, and generalized anxiety disorder, and smartphone overdependence of multicultural adolescents and general adolescents and to identify factors related to smartphone overdependence.

Research Methods

Subject of study

The data of the 16th online survey of health behavior of adolescents conducted by the Ministry of Education, the Ministry of Health and Welfare, and the Centers for Disease Control and Prevention in 2020 [14] were used for the first graders of middle school through the third graders of high school. The subjects were 39,987 students, 1,065 multicultural students who answered 'no' to the question of whether their father or mother were born in Korea and 38,922 ordinary students who answered that both their parents were born in Korea.

Research instruments

Among the data from the 16th Online Youth Health Behavior Survey, questions related to stress perception rate, depression experience rate, pan-anxiety disorder, and Internet addiction corresponding to the mental health area were used.

Stress awareness and depression experience were measured as a single question, stress awareness was measured as a 5-point scale, and depression experience was measured as presence or absence.

Generalized anxiety disorder is a total of seven items consisting of a four-point scale of 'not at all' (0) and 'almost every day'(3). The score range is 0 to 21 points, and according to the total score, 0-4 points are minimal, 5-9 points are mild, 10-14 points are moderate, and 15-21 points are classified as severe. The higher the score, the higher the anxiety. The items related to internet addiction were the average smartphone usage time during the week and weekend, and the smartphone overdependence scale for adolescents, which consisted of 10 items in the sub-areas such as regulation failure (3 items), salience (3 items), and problem result (4 items). The score range is 10 to 40 points, and it is classified into a potential risk group with a total score of 23 points - 30 points, and a high-risk group with 31 points or more. The higher the score, the more smartphone overdependence.

Data analysis

The 16th online survey on the health behavior of adolescents was conducted by the stratification step cluster extraction method, so this study used a complex sample analysis method considering stratification variable, cluster variable, and weight.

The data were analyzed by using SPSS/WIN 22.0 program and complex sample analyses were conducted to compare general characteristics, stress recognition, depression experience, generalized anxiety disorder, and smartphone overdependence of multicultural adolescents and general adolescents. To identify factors related to smartphone overdependence of multicultural adolescents and general adolescents, binomial logistic regression analysis was conducted by classifying normal use group and risk group (high-risk group and potential risk group).

Results

The subjects of this study were 1,065 multicultural adolescents (2.2%), and 38,922 general adolescents (97.8%). In the comparison of general characteristics between multicultural adolescents and general adolescents, there were significant difference in age (x2=16.77, p<.001), grade (x2=19.46, p<.001), academic achievement (x2=29.90, p<.001), economic status (x2=106.10 p<.001), and residential form (x2=10.06, p<.001) (Table 1).

Variables Categories Total
(n=39,987)
Multi-cultural family
(n=1,065)
General family
(n=38,922)
X2 p
n B (%) SE n B (%) SE n B (%) SE
Gender Male 19,247 48.3 1.2 497 46.1 2.0 18,750 48.3 1.2 1.554 .213
Female 20,740 51.7 1.2 568 53.9 2.0 20,172 51.7 1.2
Age*
(years)
mean=14.91
SE=.026
12 2,405 5.9 0.2 124 11.9 1.0 2,281 5.8 0.2 16.777 P<.001
13 7,933 19.3 0.3 276 25.1 1.4 7,657 19.2 0.3
14 7,251 16.9 0.3 202 17.3 1.2 7,049 16.8 0.3
15 6,739 16.1 0.2 185 17.3 1.3 6,554 16.1 0.2
16 6,220 16.3 0.3 109 11.3 1.1 6,111 16.4 0.3
17 5,779 15.5 0.3 90 10.0 1.0 5,689 15.6 0.3
18 3,599 10.1 0.2 66 7.1 0.8 3,533 10.2 0.2
Grade Middle school 1st 8,211 20.3 0.3 350 32.4 1.6 7,861 20.0 0.4 19.461 P<.001
2nd 7,427 17.3 0.3 214 17.2 1.1 7,213 17.3 0.3
3rd 6,880 15.8 0.3 189 17.2 1.3 6,691 15.7 0.3
High school 1st 6,221 16.2 0.3 128 13.3 1.2 6,093 16.3 0.3
2nd 5,949 15.7 0.3 94 9.9 1.0 5,855 15.8 0.3
3rd 5,299 14.8 0.3 90 10.0 1.0 5,209 14.9 0.3
Academic performance High 15,431 38.8 0.4 292 27.6 1.4 15,139 39.0 0.4 29.907 P<.001
Medium 12,153 30.2 0.2 342 31.5 1.6 11,811 30.2 0.2
Low 12,403 31.0 0.3 431 40.9 1.6 11,972 30.7 0.3
Economic status High 16,198 41.5 0.4 239 22.6 1.4 15,959 42.0 0.4 106.109 P<.001
Medium 19,173 47.4 0.4 572 53.4 1.6 18,601 47.2 0.4
Low 4,616 11.1 0.2 254 24.0 1.4 4,362 10.8 0.2
Residence type Living with family 38,433 97.0 0.2 1,011 95.1 0.7 37,422 97.0 0.2 10.069 P<.001
Living with relatives 124 0.3 0.0 5 0.7 0.3 119 0.3 0.0
Boarding 116 0.3 0.0 4 0.6 0.3 112 0.3 0.0
Living in dormitory 1,279 2.4 0.2 36 2.6 0.4 1,243 2.4 0.2
Living in care facility 35 0.1 0.0 9 1.0 0.3 26 0.1 0.0

Table 1: General characteristics according to multi-cultural and general family in Korean adolescent (N=39,987).

There was no significant difference in the stress awareness (p=.944), depression experience (p=.345), generalized anxiety disorder (p=.077), and overdependence on the smartphone (p=.349) between multicultural and general adolescents (Table 2). However, in the sub-area of smartphone overdependence, the multicultural youth showed significantly higher control failure than the general youth. (p=.05) Also, the time of using smartphones during the week (p<.001) and on weekends (p<.001) were significantly higher in multicultural adolescents than in general adolescents (Table 3).

    Total Multi-cultural adolescent General adolescent X2 p
Variables Categories (n=39,987) (n=1,065) (n=38,922)
    n B (%) SE n B (%) SE n B (%) SE    
Stress  Feel extremely stressed 3,132 7.8 0.2 87 8.2 0.9 3,045 7.8 0.2 0.185 0.944
awareness Feel a lot of stress 10,193 25.7 0.3 265 25.2 1.5 9,928 25.7 0.3
  Feel a little stress 17,898 44.8 0.3 479 45.1 1.6 17,419 44.8 0.3
  Do not feel much stress 7,320 18.1 0.2 193 17.7 1.2 7,127 18.2 0.2
  Do not feel stressed at all 1,444 3.5 0.1 41 3.8 0.6 1,403 3.5 0.1
Depression Yes 9,754 24.5 0.3 273 25.8 1.3 9,481 24.5 0.3 0.893 0.345
experience No 30,233 75.5 0.3 792 74.2 1.3 29,441 75.5 0.3
Classification of generalized anxiety disorder Minimal 26,683 66.4 0.3 696 64.5 1.6 25,987 66.5 0.3 1.038 0.374
Mild 8,856 22.3 0.2 237 23.1 1.3 8,619 22.3 0.2
Moderate 3,037 7.7 0.2 87 8 0.8 2,950 7.7 0.2
Severe 1,411 3.5 0.1 45 4.4 0.6 1,366 3.5 0.1
  mean (SE) mean (SE) mean (SE) CE(SE) p
Generalized anxiety disorder 3.96(.033) 4.23(.150) 3.96(.034) .270(.152) 0.077

Table 2: Comparison of mental health according to the multi-cultural and general family in Korean adolescent (N=39,987).

    Total Multi-cultural adolescent General adolescent    
Variables Categories (n=39,987) (n=1,065) (n=38,922) X2 p
    n B (%) SE n B (%) SE n B (%) SE    
Smartphone overdependence Classification Normal group 29,903 74.4 0.3 786 73.9 1.3 29,117 74.4 0.3 1.84 0.16
Potential risk group 8,906 22.6 0.3 237 22.1 1.3 8,669 22.6 0.3
High-risk group 1,178 3 0.1 42 4 0.6 1,136 3 0.1
  mean SE mean SE mean SE CE*(SE) p
Total 18.68 0.046 18.85 0.191 18.67 0.046 .182(.94) 0.349
Sub-area Regulation failure 6.53 0.02 6.69 0.083 6.52 0.02 .165(.084) 0.05
Salience 5.63 0.015 5.59 0.067 5.63 0.015 -.034(.069) 0.625
Problem result 6.51 0.014 6.56 0.073 6.51 0.014 .050(.076) 0.505
Smartphone usage time during the week 282.84 1.815 333.9 7.339 277.27 1.886 56.624(7.345) P<.001
(minutes)
Smartphone usage time during the weekend 393.41 2.372 478.67 8.299 388.5 2.519 90.166(8.380) P<.001
(minutes)

Table 3: Comparison of the smartphone overdependence according to the multi-cultural and general family in Korean adolescent (N=39,987).

There were significant differences in gender (p<.001) and academic achievement (p=.001, p=.007) in overdependence on smartphones according to the general characteristics of multicultural family students. There were significant differences in gender (p<.001), age (p=.004), academic achievement (p<.001), economic status (p<.001), and residence type(p=.001) for general family students (Table 4).

    Multi-cultural family     General family    
Variables Categories (n=1,065) CE*(SE) p (n=38,922) CE*(SE) p
    mean SE     mean SE    
Gender Mail 18.79 0.62 -1.540(.387) P<.001 17.63 0.114 -1.801(.074) P<.001
Female 20.33 ,577 19.43 0.115
Age Under 15 19.52 0.729 -.076(.883) 0.932 18.32 0.127 -.416(.145) 0.004
(years) Over 16 19.6 0.707 18.74 0.133
Grade Middle school 19.82 0.653 .518(.783) 0.509 18.4 0.134 -.255(.152) 0.094
High school 19.3 0.723 18.66 0.13
Academic performance High 18.98 .656) -1.524(.469) 0.001 17.97 0.117 -1.352(.082) P<.001
Medium 19.2 0.636 -1.309(.482) 0.007 18.31 0.118 -1.013(.079) P<.001
Low 20.51 0.607     19.32 0.117    
Economic status High 19.33 0.722 -.643(.601) 0.286 18.17 0.115 -.787(.105) P<.001
Medium 19.39 0.583 -.575(.491) 0.243 18.47 0.112 -.488(.103) P<.001
Low 19.97 0.626            
Residence type Living with family 18.53 0.255 -2.061(1.111) 0.064 18.89 0.044 .711(.209) 0.001
Do not living with family 20.59 1.093 18.18 0.208

Table 4: Smartphone overdependence of multi-cultural and general family adolescent according to general characteristics in Korea (N=39,987).

Significant variables related to smartphone overdependence of multicultural adolescents were academic performance (p=.045), stress awareness (p<.001), and anxiety disorder (p<.001). The smartphone overdependence was found to be higher in the case of middle-level academic achievement than in the case of high-level. Recognizing stress (p<.001), and the higher the anxiety disorder (p<.001), the higher the dependence on smartphones (Table 5).

Variable Categories Multi-cultural family (n=1,065) General family (n=38,922)
B SE P Exp(B) 95%CI** B SE P Exp(B) 95%CI**
Low High Low High
Gender Male .054 .158 .733 1.056 .773 1.441 -.284 .028 P<.001 .032 .022 .046
Age   .089 .081 .272 1.093 .933 1.281 .113 .014 P<.001 1.119 1.090 1.149
Grade High school -.506 .272 .064 .603 .353 1.030 -.217 .052 P<.001 .805 .728 .891
Academic performance Medium .394 .196 .045 1.483 1.009 2.180 .409 .031 P<.001 1.506 1.418 1.599
Low .009 .221 .968 1.009 .653 1.559 .128 .030 P<.001 1.137 1.071 1.207
Economic status Medium -.108 .211 .610 .898 .593 1.359 .050 .038 .194 1.051 .975 1.134
Low -.003 .191 .986 .997 .685 1.451 .-.009 .026 .715 .991 .942 1.042
Residence type Do not living with family .053 .389 .892 1.054 .491 2.265 -.250 .086 .004 .779 .658 .923
Stress awareness Yes .876 .231 P<.001 2.402 1.525 3.783 .312 .034 P<.001 1.366 1.279 1.459
Depression
experience
Yes -.007 .187 .970 .993 .688 1.434 .096 .030 P=.001 1.101 1.038 1.167
GAD*   .103 .019 P<.001 1.109 1.069 1.150 .113 .003 P<.001 1.110 1.104 1.117

Table 5: Factors associated with smartphone overdependence of multi-cultural and general family in Korean adolescent (N=39,987).

The general family adolescents were significant variables related to smartphone overdependence such as gender (p<.001), age (p<.001), school level (p<.001), academic achievement (p<.001), residence type (p=.004), stress awareness (p<.001), depression experience (p=.001) and anxiety disorder. (p<.001) Smartphone overdependence was lower in males (p<.001), high school (p<.001), non-residential with parents (p<.001), it was found to be higher in the case of the medium, and low-level academic achievement than in the case of high-level. In the case of recognizing stress (p<.001), and experiencing depression (p=.001), and the higher the anxiety disorder (p<.001), the higher the smartphone overdependence (Table 5).

Discussion

In this study, there was no significant difference in stress awareness, depression experience, and generalized anxiety disorder between multicultural and general adolescents. This is similar to the results of the study compared to the mental health of multicultural families and Korean adolescents, which reported that there is no significant difference in stress awareness and depression [15]. However, multicultural adolescents face relatively more stress than general adolescents due to bullying with peers, school maladjustment, and poor learning at school with their rapid physical and emotional changes in adolescence [16]. They have high depression and anxiety due to their parents' low socioeconomic level and poor learning due to differences in language and culture, and have many mental health problems [17]. It was reported that multicultural adolescents experienced more depression than general adolescents [11, 12].

In this study, there was no significant difference in smartphone overdependence between multicultural youth and general youth, but multicultural youth showed significantly higher control failure than general youth in the sub area of smartphone overdependence. Also, the time of using smartphones on weekdays and weekends was significantly higher for multicultural youths. This is in part consistent with the result of classifying the smartphone overdependence risk group based on the time of using the smartphone on weekdays and weekends in Chae Myung-ok’s study [12], which shows that the overdependence rate of the smartphone on weekdays and weekends is 1.359 times higher than that of the general youth, respectively, and 1.297 times higher than that of the general youth. Multicultural adolescents have fewer peer friends than ordinary adolescents and poor emotional support relationships that share their concerns. Therefore, multicultural adolescents tend to spend more time using smartphones than ordinary adolescents [18]. The time of smartphone use is related to the overdependence of smartphones of adolescents [2], especially multicultural adolescents who have difficulty in controlling their use of smartphones are higher than ordinary adolescents, so education and support for the right use of smartphones are required.

In this study, academic achievement, stress awareness, and general anxiety disorder were found to be significant variables in both multicultural and general adolescents as factors related to smartphone overdependence. Adolescence is emotionally unstable due to rapid physical development and excessive social tasks. Adolescents experience stress and anxiety due to school life adaptation and academic achievement burden, and they can be over-dependent on smartphones because they use smartphones to avoid them [19]. It was reported consistently in previous studies that students who are addicted to smartphones have difficulty in achieving academic achievement [2, 21] and students who feel stressed [6, 20] and have high anxiety [21] are over-depended on smartphones.

Unlike multicultural adolescents in this study, factors related to the overdependence of smartphones in general adolescents were gender, age, school level, residence type, and depression experience. As a result of this study, female students were more likely to be over-depended on smartphones than male students. Previous studies [2, 22,23] consistently reported that female students are more likely to be addicted to smartphones than male students because they value interpersonal relations and communication, and often use messengers such as SNS. In addition, according to the smartphone over-dependence survey in 2019, both high-risk and potential risk groups showed that women (high risk 4.0%, potential risk 27.4%) were higher than men (high risk 3.7%, potential risk 25.5%), by school level, middle school students (4.6% at high risk and 30.1% at potential risk) were the highest. According to this study, adolescents' overdependence on smartphones has increased with age. It is contrary to the report that the age range of teenagers addicted to the Internet and smartphones is getting lower [24]. In this study, adolescents who experienced depression were found to be highly dependent on smartphones. Prior research also reported that if there is a high tendency of depression, there is a tendency to avoid difficulties in the real world and satisfy social needs in virtual space, which leads to excessive use of the Internet or smartphones [8, 25]. In this study, it was found that smartphone overdependence was low when they did not live with their parents. These results are believed to have been attributed to the dormitory residents account for a large portion of the subjects of this study, and the characteristics of the youth dormitory that keeps the discipline of common life and lives regularly. Therefore, unlike multicultural adolescents, the smartphone dependence of ordinary adolescents is related to gender, age, and school level, type of residence, and depression, which requires attention.

This study is a cross-sectional study that limits the identification of causal relationships between variables. In addition, multicultural adolescents were classified and analyzed based on the country in which their parents were born, so there is a limit to generalizing their findings.

Conclusion

It was intended to compare mental health and dependence on smartphones among teenagers from multicultural families and ordinary families and to identify factors related to smartphone dependence. There was no significant difference in mental health such as stress awareness, depression experience, and generalized anxiety disorder between adolescents from multicultural families and general adolescents. There was no significant difference in smartphone overdependence between multicultural family adolescents and general adolescents, but multicultural adolescents showed significantly higher control failure, which is the sub-area of smartphone overdependence, than general adolescents. The use time of smartphones on weekdays and weekends was significantly higher in multicultural families than in general families. In both adolescents from multicultural families and adolescents from ordinary families, smartphone overdependence was higher in the middle-level academic achievement than in the higher-level, and the higher the stress awareness and generalized anxiety disorder, the higher the possibility of smartphone overdependence. Also, the smartphone overdependence of general youth was significantly related to gender, age, school level, residence type, and depression experience.

Therefore, Education and support for the right use of smartphones for multicultural youths are required so that they can control the degree of smartphone use themselves and to prevent adolescents' overdependence on smartphones, it needs to differentiate approaches according to the characteristics of multicultural families and general family adolescents.

Acknowledgments: This study is research supported by Semyung University research year in 2021.

Funding/Support: none

Other disclosures: none

Ethical approval: n/a

Disclaimers: n/a

Previous presentations: none

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