Background and aims: Although smartphone use brings many benefits for adolescents, it is also associated with many serious health problems. This study examined the relationship between problematic smartphone use (PSU) and clinical health symptoms (e.g., body dysfunction) and the mediating effects of sleep quality on this relationship in adolescents. Methods: Participants in this cross-sectional survey were 686 middle- and high-school students (girls = 55.7%, M_age = 12.98 ± 1.38 years). Participants completed self-report measures of PSU, sleep quality, and physical symptoms. Correlation analyses and structural equation modeling between adolescents’ PSU and the variables of interest were conducted. Results: This study indicated that there was a significant positive correlation between PSU and health symptoms. Furthermore, sleep quality mediated the relationship between PSU and health symptoms. Discussion and conclusions: Findings suggest that to promote health and wellness in adolescents, individuals should be encouraged to place boundaries on smartphone use, especially at bedtime. Reducing adolescents’ exposure to smartphone use in this way may hold promise for improving the efficacy of PSU prevention efforts for adolescents.

Research has found that self-esteem is negatively associated with problematic smartphone use (PSU). However, the internal mechanisms underlying that relationship need further investigation. The purpose of this study was to investigate the roles of depression and interpersonal trust in the relationship between self-esteem and PSU among adolescents. A questionnaire comprised of the Rosenberg Self-esteem Scale, Inclusive General Trust Scale (IGTS), Self-rating Depression Scale (SDS), and personal questions was administered to 637 students (female = 355) at two middle schools in Shanghai, China. Correlation analyses, mediation analysis, and moderated mediation analysis were performed. A moderated mediation model was established, which revealed: (1) a significant negative association between self-esteem and PSU, (2) depression mediated the relationship between self-esteem and PSU, and (3) the influence of depression on the relationship between self-esteem and PSU was moderated by interpersonal trust. The results indicated that low self-esteem was a risk factor, and interpersonal trust was a moderating factor for PSU among adolescents in the sample. Building adolescents’ self-esteem and increasing their interpersonal trust might decrease their PSU.

Angry rumination and hostile attribution bias are important cognitive factors of aggression. Although prior theoretical models of aggression suggest that aggressive cognitive factors may influence each other, there are no studies examining the longitudinal relationship between angry rumination and hostile attribution bias. The present study used cross-lagged structural equation modeling to explore the longitudinal mutual relationship between hostile attribution bias and angry rumination; 941 undergraduate students (38.5% male) completed questionnaires assessing the variables at two time points. The results indicate that hostile attribution bias showed a small but statistically significant effect on angry rumination 6 months later, and angry rumination showed a quite small but marginally significant effect on hostile attribution bias across time. The present study supports the idea that hostile attribution bias influences angry rumination, and argue that the relationship between angry rumination and hostile attribution bias may be mutual. Additionally, the results suggest that there may be a causal relation of different aggression-related cognitive factors.