Ultra-wired South Korea takes smartphone addiction more seriously than any other country. Should we be following their lead? By Elizabeth Woyke (Author, The Smartphone: Anatomy of an Industry)
Sam-Wook Choi is a Korean psychiatrist who specializes in addiction research, including alcoholism, pathological gambling and nicotine dependence. In 2011, Choi began investigating a new potential addiction: to smartphones.
In the United States, most clinicians are skeptical of many technological addictions. Neither Internet addiction nor smartphone addiction is listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the principal guidebook for diagnosing and classifying mental disorders. (“Internet Gaming Disorder” does appear in an appendix to the manual’s latest edition, the DSM-5, but only as a condition requiring further study.)
Though the psychiatric establishment has been slow to add technological addictions to its repertoire of diagnoses, a growing band of clinicians in South Korea is finding evidence in favor of them.
Choi and his colleagues argue that they have met and treated not only internet addicts but smartphone addicts. Though smartphone addiction shares “many functional or psychological properties with internet use,” as he and his colleagues noted in a recent paper, they contend that the two disorders are distinct.
Smartphone Addicts versus Internet Addicts
They have found that internet addicts typically spend most of their time playing online games, whereas smartphone junkies devote more time to social networking applications.
As Uichin Lee, a professor at Korea Advanced Institute of Science & Technology (KAIST), explains, smartphones “are usually a means of communication between people who have actual relationships. Smartphone addicts may think they are strengthening their real-world relationships [when using their phones] when in actuality they are overusing some apps for relationship management.”
Perhaps because of this focus on relationships, smartphone addicts tend to be female whereas internet addicts skew male, though statistics on the exact gender split are hard to come by.
Why South Korea?
If smartphone addiction were to arise anywhere, South Korea is probably the place: it is home to two smartphone giants – Samsung and LG – and boasts some of the world’s fastest 4G LTE connections.
More than 80% of Koreans own smartphones, compared to about 70% of Americans, and on average they spend more than four hours a day on their phones. South Korea also has a history of public concern and government intervention regarding internet addiction. A few years ago, the Korean government began underwriting studies and surveys related to smartphone addiction, well ahead of the rest of the world.
Choi readily admits that smartphone addiction research is still in its infancy. The studies so far have been small in scale and short in duration. Standardized diagnostic criteria don’t yet exist. Korean researchers have developed several self-rating questionnaires for assessing smartphone addiction, but no single one of them is regarded as official.
Though some neuroscientists have suggested that internet addiction can alter the brain in ways similar to alcohol and drug addictions, researchers have yet to provide similar data for smartphone addiction.
“If you go into PubMed [the search engine for the National Library of Medicine, the world’s largest biomedical library] there are maybe 20 articles that include ‘smartphone addiction’ as a term, and most of those articles just talk about smartphone addiction as a phenomenon,” notes Choi. “If we want to really call smartphone addiction an addiction, we have to provide biological evidence of things like reward pathways and circuits, because all addictions have them.”
But Choi also points out that behavioral addictions often surface first as social problems, with scientific explanations following later. “It can take many, many years to find the medical evidence,” he says.
Currently, Korean clinicians define smartphone addiction as excessive use that hinders users’ daily lives and triggers symptoms of craving, mood modification and withdrawal. In one recent study, Choi and several colleagues wrote that smartphone addiction, like other impulse-control disorders, can “interfere with school or work; decrease real-life social interaction; decrease academic ability; and cause relationship problems.”
Because smartphones are portable and easy to conceal, identifying overuse is more difficult than with PC-based online gaming. As a result, researchers feel some urgency to better characterize this condition. Below are a few things Korean researchers have learned so far about smartphone addiction:
1. Smartphone Addicts Tend to use Their Phones in a Distinctive Way
Smartphone addiction is not simply a matter of overuse. Yes, these addicts log more time on their phones than non-addicts (22% more, according to one study) but problematic smartphone usage stems more from how and why people use their phones.
For example, a recent study by Lee, the KAIST professor, found that people who turn to their smartphones for “mood adjustment purposes,” such as to relieve boredom, stress or depression, may form a habit of using their phones for those objectives, which can lead to addictive behaviors.
Lee also found that addicts used their phones for longer periods in the evening (6 p.m. to midnight) than “non-risk” users. In addition, addicts repeatedly surfed the mobile web in search of “instant gratification” content, such as news updates, and they were easily distracted by incoming alerts from mobile messenger and social networking apps, such as KakaoTalk (which is similar to WhatsApp) and Facebook.
Heejune Ahn, a professor at Seoul National University of Science and Technology, similarly found that addicts gravitate toward messaging and social networking apps and use their phones more between the hours of 11 p.m. and 3 a.m. than non-addicts.
The researchers say that smartphone addicts have limited self-control and thus tend to frequently check messaging and social networking apps – particularly in response to update notifications – and also let their smartphone usage keep them up at night.
2. Software can Identify Problematic Smartphone Users
Both Ahn and Lee independently developed custom Android apps that log how people use their phones so as to identify potential signs of addiction. Lee’s software leverages Android’s “accessibility service” feature, which Google originally created to assist disabled users. It can detect everything from user actions within apps to a phone’s overall status, such as whether the screen is powered on or off.
Both professors recruited participants for their experiments by explaining how their software worked and asking people to download their apps. They also conducted diagnostic questionnaires and/or in-person interviews with their study subjects to gauge the severity of a person’s addiction or potential addiction. Then, the professors observed how “high-risk” participants used their phones versus the way “non-risk” volunteers did.
Ahn and Lee discovered that smartphone addicts are distinct enough in their usage patterns that software can be trained to automatically identify them.
After they gathered their initial datasets, the professors marshaled the information to teach algorithms how to detect problematic users. (Their apps transmit user data to cloud-based servers for analysis. Machine-learning algorithms then determine user risk based on usage patterns.)
“We put new users’ usage data into the algorithm, and it classifies whether they are addicted or not,” explains Lee. He compared the algorithm’s results with his diagnostic questionnaire findings and says his software is able to classify addicts with accuracy as high as 87%.
3. Apps Alone Can’t Cure Addicts
Over the past year or so, several smartphone addiction intervention apps have popped up in the iOS App Store and Google Play. These apps pledge to help users regain control of their smartphone usage by monitoring their phone and app activity and notifying them of overuse. Ahn’s app has similar features that enable users to see which apps they use the most and how much time they have spent within a particular app over the past seven days.
The users of Ahn’s app, however, did not end up modifying their habits. “I found that the app, by itself, doesn’t provide great benefits or effectiveness to addicted people,” Ahn concedes. His conclusion: “It should be accompanied by some kind of counseling process.”
Choi, who often collaborates with Ahn, agrees. “Motivation is the most important factor [in battling addiction],” says Choi. “Addicts have to be motivated to change their behavior.” Choi says some people may find these apps adequate, but “severe” smartphone addicts require classical intervention, such as counseling or cognitive-behavioral therapy.
This is key because smartphone addiction has been linked to disorders such as anxiety and depression. “We have to figure out what is the primary disorder and what is secondary,” Choi says. Apps, he says, can “provide add-on effectiveness” to these more conventional methods.
One question that these researchers have yet to scrutinize is whether smartphone addiction is a uniquely Korean problem. Choi thinks Korean teenagers, for example, may be particularly vulnerable to smartphone addiction because they spend a lot of time in school and in after-school tutoring programs.
“Korean students don’t have much time to relax,” says Choi. “Instead, they rely on their smartphones for leisure.” Choonsung Shin, a Korean technology researcher who has examined problematic smartphone usage in both Korea and the U.S., says cultural differences could affect smartphone addiction rates, but he notes that factors such as a person’s age, gender and occupation are also likely to play a role.
We have yet to learn if smartphone addiction is a global phenomenon. But at least one thing is clear: our phones have a way of getting inside our heads.