Friday, August 28, 2015

What is nomophobia & how is it assessed?

What is nomophobia & how is it assessed?

"Nomophobia is the fear of being out of mobile phone contact.[1][2][3] It is, however, arguable that the word "phobia" is misused and that in the majority of cases it is only a normal anxiety.[4]Although nomophobia does not appear in the current DSM-V, it has been proposed as a "specific phobia", based on definitions given in the DSM-IV.[5] According to Bianchi and Philips (2005) psychological factors are involved in the overuse of a mobile phone.[6] These could include low self-esteem, when individuals looking for reassurance use the mobile phone in inappropriate ways, and extroverted personality, when naturally social individuals use the mobile phone to excess. It is also highly possible that nomophobic symptoms may be caused by other underlying and preexisting mental disorders, with likely candidates including social phobia or social anxiety disorder, social anxiety,[7] andpanic disorder.[8]" Wikipedia

Are you a nomophobe?

News Service, Iowa State University, Aug 26, 2015

Two-minute video and brief article describing the following new study by Yildrim and Correia.

Yildrim C., Correia A-P. Exploring the dimensions of nomophobia: Development and validation of a self-reported questionnaire. Computers in Human Behavior. 49:130-137. August 2015.


• Nomophobia was investigated as a theoretical construct among young adults.
• Dimensions of nomophobia were identified and described.
• The Nomophobia Questionnaire (NMP-Q) was devised and validated.
• The NMP-Q can be used as a measure of nomophobia.
• Nomophobia can be considered a situational phobia and included in DSM-5.


Nomophobia is considered a modern age phobia introduced to our lives as a byproduct of the interaction between people and mobile information and communication technologies, especially smartphones. This study sought to contribute to the nomophobia research literature by identifying and describing the dimensions of nomophobia and developing a questionnaire to measure nomophobia. Consequently, this study adopted a two-phase, exploratory sequential mixed methods design. The first phase was a qualitative exploration of nomophobia through semi-structured interviews conducted with nine undergraduate students at a large Midwestern university in the U.S. As a result of the first phase, four dimensions of nomophobia were identified: not being able to communicate, losing connectedness, not being able to access information and giving up convenience. The qualitative findings from this initial exploration were then developed into a 20-item nomophobia questionnaire (NMP-Q). In the second phase, the NMP-Q was validated with a sample of 301 undergraduate students. Exploratory factor analysis revealed a four-factor structure for the NMP-Q, corresponding to the dimensions of nomophobia. The NMP-Q was shown to produce valid and reliable scores; and thus, can be used to assess the severity of nomophobia.

According to Pew Research Center’s Mobile Technology Fact Sheet (2014), as of January 2014, 90% of the American adult population have some kind of a cell phone and 58% of American adults own a smartphone ... college students are regarded as the early adopters of smartphones (Lee, 2014).

... Previous studies have shown that smartphones may cause compulsive checking habits (Oulasvirta et al., 2012), that smartphones may lead to compulsive usage and increased distress (Lee, 2014 and Matusik and Mickel, 2011), and that smartphones can be addictive (Chiu, 2014, Lee, 2014 and Salehan and Negahban, 2013).

Another problem exacerbated by smartphones is nomophobia. Nomophobia, or no mobile phone phobia, is “the fear of being out of mobile phone contact” (SecurEnvoy, 2012, para. 1). The term, nomophobia, is an abbreviation for no-mobile-phone phobia, and it was first coined during a study conducted in 2008 by the UK Post Office to investigate anxieties mobile phone users suffer (SecurEnvoy, 2012). The 2008 study in the UK, conducted with over 2100 people, demonstrated that some 53% of mobile phone users suffered from nomophobia (Mail Online, 2008). The study also revealed that men were more prone to nomophobia than were women, with 58% of male participants and 48% of female participants indicating feelings of anxiety when unable to use their phone.

Another study conducted in the UK (SecurEnvoy, 2012) surveyed 1000 employees and showed that the number of people suffering from nomophobia increased from 53% to 66%. Unlike the 2008 study, the 2012 study found out that women were more susceptible to nomophobia, with 70% of the women compared to 61% of the men expressing feelings of anxiety about losing their phone or not being able to use their phone (SecurEnvoy, 2012). In terms of the relationship between age and nomophobia, the study found that young adults, aged 18–24 were most prone to nomophobia with 77% of them identified as nomophobic, followed by users aged 25–34 at 68%. Moreover, mobile phone users in the 55 and over group were found to be the third most nomophobic users.

In one of the very first research studies into nomophobia (King, Valença, & Nardi, 2010), nomophobia is considered a 21st century disorder resulting from new technologies. In this definition, nomophobia “denotes discomfort or anxiety when out of mobile phone (MP) or computer contact. It is the fear of becoming technologically incommunicable, distant from the MP or not connected to the Web” (King et al., 2010, p. 52). Thus, this definition seems to encompass not only mobile phones but computers, as well. In another study (King et al., 2013), nomophobia is defined as “a disorder of the modern world [that] has only recently been used to describe the discomfort or anxiety caused by the non-availability of an MP, PC or any other virtual communication device in individuals who use them habitually” (p. 141). Although their definition includes the unavailability of computers, they argue that computers are replaced by mobile phones, which presumably have smartphone capabilities, and tablets. Therefore, they state that their research focus is less on computers and more on virtual communication environments, including mobile phones (King et al., 2013, p. 142). Their definition implies a dependency on virtual environments for communication. In a recent study (King et al., 2014), nomophobia is defined as follows:

Nomophobia is the modern fear of being unable to communicate through a mobile phone (MP) or the Internet. … Nomophobia is a term that refers to a collection of behaviors or symptoms related to MP use. Nomophobia is a situational phobia related to agoraphobia and includes the fear of becoming ill and not receiving immediate assistance (p. 28).

The present study discusses nomophobia in relation to smartphones. As King et al. (2010) propose, nomophobia is considered a modern age phobia and a byproduct of the interaction between individuals and new technologies. Over the last five years, smartphones have taken over the mobile phone market and have almost replaced the phrase “mobile/cell phone” With their numerous capabilities, smartphones facilitate instant communication, help people stay connected anywhere anytime, and provide people with constant access to information. Thus, people have become dependent on their mobile phones more than ever (Park et al., 2013), which, in turn, supposedly exacerbates the feelings of anxiety caused by being out of mobile phone contact. That connection is why nomophobia should be considered in relation to smartphones, which have the standard capabilities of a cell phone, (e.g., phone calls, texting, etc.) and have more advanced capabilities like internet access, applications, or sensors (Park et al., 2013).

Although there has been an increasing academic interest in investigating the problems emanating from smartphone use, research into nomophobia has been scarce (King et al., 2013 and King et al., 2014). Thus, the purpose of this two-phase, exploratory mixed methods study was to explore the dimensions of nomophobia with the intent of using these findings to develop and validate a self-reported questionnaire to measure nomophobia among U.S. college students. To our best knowledge, this study is the first to devise a self-reported measure to assess the severity of nomophobia among college students.

Table 1. The 20 items in the NMP-Q.
1. I would feel uncomfortable without constant access to information through my smartphone
2. I would be annoyed if I could not look information up on my smartphone when I wanted to do so
3. Being unable to get the news (e.g., happenings, weather, etc.) on my smartphone would make me nervous
4. I would be annoyed if I could not use my smartphone and/or its capabilities when I wanted to do so
5. Running out of battery in my smartphone would scare me
6. If I were to run out of credits or hit my monthly data limit, I would panic
7. If I did not have a data signal or could not connect to Wi-Fi, then I would constantly check to see if I had a signal or could find a Wi-Fi network
8. If I could not use my smartphone, I would be afraid of getting stranded somewhere
9. If I could not check my smartphone for a while, I would feel a desire to check it

If I did not have my smartphone with me,
10. I would feel anxious because I could not instantly communicate with my family and/or friends
11. I would be worried because my family and/or friends could not reach me
12. I would feel nervous because I would not be able to receive text messages and calls
13. I would be anxious because I could not keep in touch with my family and/or friends
14. I would be nervous because I could not know if someone had tried to get a hold of me
15. I would feel anxious because my constant connection to my family and friends would be broken
16. I would be nervous because I would be disconnected from my online identity
17. I would be uncomfortable because I could not stay up-to-date with social media and online networks
18. I would feel awkward because I could not check my notifications for updates from my connections and online networks
19. I would feel anxious because I could not check my email messages
20. I would feel weird because I would not know what to do
... Cronbach’s alpha reliability coefficient for internal consistency of the questionnaire is .945, indicating that the questionnaire has good internal consistency (DeVellis, 2003, Field, 2009 and Nunnally, 1978) ... The alpha coefficients of Factor I – not being able to communicate – (6 items), Factor II – losing connectedness – (5 items), Factor III – not being able to access information – (4 items) and Factor IV – giving up convenience – (5 items) were .939, .874, .827, and .814, respectively (see Table 4). They were all above the commonly accepted minimum value of .7 (Nunnally, 1978), suggesting that they demonstrate good internal consistency.

In an attempt to address the scarcity of research into nomophobia, this study explored the dimensions of nomophobia, devised the NMP-Q as self-reported measure to assess the severity of nomophobia, and provided empirical support for the validity and reliability of the NMP-Q. Future research should seek to further investigate the psychometric properties of the NMP-Q and to explore the psychological mechanisms underlying nomophobia. Especially, studies examining the psychological factors comorbid with nomophobia are imperative. Moreover, further investigation into the prevalence of nomophobia among different demographic groups in diverse contexts are needed. For instance, a previous study revealed that females were more susceptible to nomophobia when compared to males (SecurEnvoy, 2012). Conversely, in another study, males were shown to be more likely to demonstrate nomophobic behaviors than males (Mail Online, 2008). Given these inconsistent results, further investigation is needed to disentangle whether males and females differ in their proclivity to nomophobia. In addition, future research should aim to determine which factors predict nomophobia, which can be useful for identifying the risk groups and developing prevention strategies to help those groups cope with nomophobia. Overall, we envisage that further investigation into the phenomenon of nomophobia is viable, and that the NMP-Q, as a self-reported measure of nomophobia, can be useful for future research.

Other Research on Nomophobia
Bragazzi NL, Del Puente G. A proposal for including nomophobia in the new DSM-V. Psychol Res Behav Manag. 2014 May 16;7:155-60. doi: 10.2147/PRBM.S41386. eCollection 2014.


The Diagnostic and Statistical Manual of Mental Disorders (DSM) is considered to be the gold standard manual for assessing the psychiatric diseases and is currently in its fourth version (DSM-IV), while a fifth (DSM-V) has just been released in May 2013. The DSM-V Anxiety Work Group has put forward recommendations to modify the criteria for diagnosing specific phobias. In this manuscript, we propose to consider the inclusion ofnomophobia in the DSM-V, and we make a comprehensive overview of the existing literature, discussing the clinical relevance of this pathology, its epidemiological features, the available psychometric scales, and the proposed treatment. Even though nomophobia has not been included in the DSM-V, much more attention is paid to the psychopathological effects of the new media, and the interest in this topic will increase in the near future, together with the attention and caution not to hypercodify as pathological normal behaviors.


King AL, Valença AM, Silva AC, Sancassiani F, Machado S, Nardi AE."Nomophobia": impact of cell phone use interfering with symptoms and emotions of individuals with panic disorder compared with a control group. Clin Pract Epidemiol Ment Health. 2014 Feb 21;10:28-35. doi: 10.2174/1745017901410010028. eCollection 2014. 


Panic disorder refers to the frequent and recurring acute attacks of anxiety.

OBJECTIVE: This study describes the routine use of mobiles phones (MPs) and investigates the appearance of possible emotional alterations or symptoms related to their use in patients with panic disorder (PD).

BACKGROUND: We compared patients with PD and agoraphobia being treated at the Panic and Respiration Laboratory of The Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil, to a control group of healthy volunteers.

METHODS: An MP-use questionnaire was administered to a consecutive sample of 50 patients and 70 controls.

RESULTS: People with PD showed significant increases in anxiety, tachycardia, respiratory alterations, trembling, perspiration, panic, fear and depression related to the lack of an MP compared to the control group.

CONCLUSIONS: Both groups exhibited dependence on and were comforted by having an MP; however, people with PD and agoraphobia showed significantly more emotional alterations as well as intense physical and psychological symptoms when they were apart from or unable to use an MP compared to healthy volunteers


King AL, Valença AM, Nardi AE. Nomophobia: the mobile phone in panic disorder with agoraphobia: reducing phobias or worsening of dependence? Cogn Behav Neurol. 2010 Mar;23(1):52-4. doi: 10.1097/WNN.0b013e3181b7eabc.


OBJECTIVE: In this report, we present and discuss a hypothesis for the development, in individuals with panic disorder and agoraphobia, of dependence on his or her mobile phone (MP).

BACKGROUND: This disorder, termed nomophobia, is a result of the development of new technologies. Nomophobia is considered a disorder of the modern world and refers to discomfort or anxiety caused by being out of contact with a MP or computer. It is the pathologic fear of remaining out of touch with technology.

METHOD: We present, the case report of a patient who has continuously kept his MP with him since 1995 because of his overwhelming need to feel safe and to be able to immediately call emergency services and people he trusts should he feel sick.

RESULT: The patient was treated with medication and cognitive-behavior psychotherapy. He has remained asymptomatic for 4 years. The patient showed significant medical improvement in his panic disorder and phobias, but there has been no change in his nomophobia.

CONCLUSIONS: The case presented here illustrates the dependence of an individual with panic disorder on his MP. A specific approach for this dependence should be used in some panic disorder patients.

Joel M. Moskowitz, Ph.D., Director
Center for Family and Community Health
School of Public Health
University of California, Berkeley

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