Investigating the Relationship Between Problematic Smartphone Use, Intolerance of Uncertainty, And Mindfulness

Abstract

Problematic smartphone use (PSU) describes subjective distress, impairment, and/or negative consequences in important areas of functioning due to an inability to regulate smartphone usage (Billieux, 2012; Merlo et al., 2013). PSU is correlated with several mental health concerns, including symptoms of depression, anxiety, and perceived stress (Demirci et al., 2015; Elhai et al., 2017; Elhai et al., 2019; Samaha et al., 2016). Intolerance of uncertainty (IU) is related to numerous anxiety-related disorders (Carleton 2016a, 2016b) and may be a transdiagnostic cognitive mechanism relevant to PSU. A statistically significant increase in IU and smartphone usage from 1999 to 2014 suggests a relationship between IU and increasing smartphone use (Carleton et al., 2019). Smartphone use may increase access to reassurance, therein acting as a safety cue for those with heightened levels of IU (Carleton et al., 2019). Online mindfulness-based interventions (MBIs) may be an easily-accessible option for reducing IU and PSU, by increasing awareness and non-judgmental observations of the present moment (Bishop et al., 2004). Online MBIs produce reductions in anxiety-related symptoms (e.g., Cavanagh et al., 2013; Krusche et al., 2013; Querstret et al., 2018), but have not been explored as targeted interventions for IU and PSU. The current randomized control trial aimed to: 1) assess the effectiveness of an online MBI in reducing IU, PSU, and anxiety-related symptoms, and increasing mindfulness; 2) assess whether an accurate measure of smartphone use is associated with IU over time; and 3) assess whether PSU is associated with IU over time. Eligible participants were randomized to one of the following groups: 1) Waitlist Control condition, 2) Active Control condition (actively reducing smartphone use), or 3) MBI Treatment condition. Primary outcome measures of PSU, IU, and mindfulness, as well as secondary outcome measures of anxiety-related symptoms, were completed by participants once per week for five weeks while participants were asked to record their smartphone use via a smartphone monitoring application. Participants in the MBI Treatment condition participated in a weekly online MBI for four weeks. Participants in the Active Control condition were asked to decrease their smartphone use each week and watch a nature film equivalent to the length of the MBI videos each week. Multilevel linear modeling was used to test the effectiveness of the online MBI in reducing levels of IU, PSU, and anxiety-related symptoms, and increasing levels of mindfulness. Correlational analyses were used to assess the relationship between IU, smartphone use, and PSU over time. Participants in the MBI Treatment condition demonstrated superiority in decreasing symptoms of anxiety, relative to the Waitlist Control condition, but not the Active Control condition. Participants in the MBI Treatment condition also demonstrated superiority in increasing levels of mindfulness relative to both Control conditions, particularly at later time points. Across conditions, levels of IU and depression decreased over time, and initial levels of mindfulness increased, suggesting a possible effect of the smartphone monitoring application. Further, the MBI Treatment and Active Control conditions appear to be effective in reducing PSU. Lastly, PSU, but not general smartphone use, appears to be related to IU over time; therefore, how one uses their smartphone may be more relevant to IU than how much one uses their smartphone.