The role of self-control in the bidirectional relation between problematic smartphone use and generalized anxiety...

Despite the high prevalence of problematic smartphone use (PSU) and generalized anxiety symptoms among individuals with major depressive disorder (MDD), their symptom-level interplay remains unclear. The Interaction of Person-Affect-Cognition-Execution model emphasizes that self-control may moderate the relation between generalized anxiety symptoms and PSU. However, the dynamic role of self-control in this relation at the symptom level over time is poorly understood.

A total of 2469 secondary school students completed questionnaires in two waves, including the Mobile Phone Addiction Index, Patient Health Questionnaire, Generalized Anxiety Disorder Scale, and Self-Control Scale, assessing MDD, PSU, generalized anxiety, and self-control. Using a cutoff of 8, 169 (prevalence is 6.84 %, male = 73 (43.2 %), age _mean±SD = 14.50 ± 1.61) were screened as depressed and included in the analysis. A novel multivariate network model was employed to examine the bidirectional relation between PSU and anxiety when moderating self-control among students with MDD.

The inability to control craving was stable central symptom in two waves. Notably, anxiety symptoms linked to problematic smartphone use shifted from internalized symptoms (e.g., feeling afraid, nervousness) to externalized symptoms (e.g., restlessness). Additionally, self-control moderated the bidirectional relation between PSU (i.e., feeling anxious and lost) and generalized anxiety symptoms (i.e., restlessness) in the first wave, with higher self-control strengthening this bidirectional association among depressed secondary students.

The findings emphasized the potential role of self-control in the symptom-level association between PSU and anxiety, providing implications for targeted interventions in depressed students, such as acceptance and commitment therapy.