By Emma Young

Smartphone addiction (SA) is a controversial concept that is not recognised by psychiatry as a formal diagnosis. Critics say that a problematic relationship with one’s phone is usually a symptom of deeper underlying issues and that it is inappropriate to apply the language of addiction to technology. Nonetheless, other mental health experts believe SA is real and they’ve accumulated evidence suggesting it is associated with reductions in academic and work performance, sleep disorders, symptoms of depression and loneliness, declines in wellbeing – and an increased risk of road traffic accidents. According to a group of psychiatry and psychology researchers at one of the largest universities in Brazil, to that list can now be added: poorer decision-making.

Studies suggest that the numbers of people with notional SA (defined by difficulty in controlling use of the smartphone, constant preoccupation with the possibility of being without it, and poor mood when it is taken away) are high – about 25 per cent of the population in the US; 10 per cent of adolescents in the UK; and a massive 43 per cent of people in Brazil, where the new research, published in Frontiers in Psychiatry, was conducted.

Previous work has found that people with other forms of dependency, including drug and gambling addiction, show impaired decision-making in ambiguous situations, though not when the risks associated with making a decision are clearly outlined. Julia Machado Khoury at the Federal University of Minas Gerais and her colleagues, including lab head Frederico Duarte Garcia, wanted to know whether the same might be true for people with SA.

Using a Brazilian version of the Smartphone Addiction Inventory, which was created in 2014, the researchers identified 47 graduate students aged 18 to 25 who scored high enough to qualify as having an addiction (according to the developers of the Inventory). The researchers then compared these students’ performance with those of 43 matched controls on two widely-used decision-making tasks. In the Iowa Gambling Task, which is meant to simulate real-life decision-making, participants must make as much money as possible by selecting face-down cards from four different decks, with each card indicating whether they’ve earned or lost money. Two decks are more advantageous in the long term, but the participants have to work this out for themselves through trial and error. In contrast, the Game of Dice Task requires participants to make as much money as possible through a series of dice throws in which the rules and the probabilities of winning different amounts are stable and so predictable throughout.

The high scorers on notional smartphone addiction performed about the same as the controls on the Game of Dice task. But they were worse, on average, at the Iowa Gambling Task – and the greater the severity of their purported addiction, as indicated by their SA inventory results, the worse their performance. As the researchers note: “Decision-making under ambiguity reflects more strongly the reality of daily decisions, which are made without prior certainty of the probability of each outcome.”

As the researchers monitored all the participants’ skin conductance data throughout, they could also look for changes in arousal, which they took to indicate responsiveness to perceived rewards or punishments. Compared with the controls, the high scorers on smartphone addiction showed lower skin conductance responsiveness before disadvantageous choices, higher responsiveness after rewards (winning) and lower responsiveness after punishments. This “suggests difficulty in recognising disadvantageous alternatives, high sensitivity to rewards and low sensitivity to punishments,” the researchers note.

They argue that the decisions of those scoring high in smartphone addiction are guided more by the search for rewards than the avoidance of punishments. They add that this could help to maintain and even worsen their addiction, and contribute to sliding academic performance and deteriorating social relationships.

Machado Koury and her colleagues suspect that people with pre-existing tendencies to favour gaining rewards over avoiding punishments may be more likely to develop smartphone addiction, which could then make these tendencies worse. Sceptical readers will note that the new research provides no evidence for this worsening effect, and may wonder about the other underlying psychological differences between the groups that could account for the findings.

For their part, the researchers argue that not only does this study help to bolster the argument that SA is a genuine addiction (the “same disease with another face”), but that the findings also have some clinical implications: “preventative strategies can focus on the development of emotional regulation, awareness of bodily signs/symptoms and postponement of rewards.” There are already effective strategies for helping people with all these things, including physical exercise, focused attention training, mindfulness, biofeedback, and cognitive behavioural therapy. Arguably then, these strategies may help people with an unhealthy relationship with their smartphone, and even prevent it from becoming problematic, whether we call that an addiction or something else.

—Bad Choices Make Good Stories: The Impaired Decision-Making Process and Skin Conductance Response in Subjects With Smartphone Addiction

Emma Young (@EmmaELYoung) is Staff Writer at BPS Research Digest