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Keywords = situational phobia

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26 pages, 13100 KiB  
Article
Usability Analysis of a Virtual Reality Exposure Therapy Serious Game for Blood Phobia Treatment: Phobos
by João Petersen, Vítor Carvalho, João Tiago Oliveira and Eva Oliveira
Electronics 2024, 13(7), 1350; https://doi.org/10.3390/electronics13071350 - 3 Apr 2024
Cited by 1 | Viewed by 2419
Abstract
Phobias are characterized as the excessive or irrational fear of an object or situation, and specific phobias affect about 10% of the world population. Blood-injection-injury phobia is a specific phobia that has a unique physical response to phobic stimuli, that is, a vasovagal [...] Read more.
Phobias are characterized as the excessive or irrational fear of an object or situation, and specific phobias affect about 10% of the world population. Blood-injection-injury phobia is a specific phobia that has a unique physical response to phobic stimuli, that is, a vasovagal syncope that causes the person to faint. Phobos is a serious game intended for blood phobia treatment that was created to be played in virtual reality with an HTC Vive that has photorealistic graphics to provide a greater immersion. We also developed a console application in C# for electrocardiography sensor connectivity and data acquisition, which gathers a 1 min baseline reading and then has continuous data acquisition during gameplay. Usability tests were conducted with self-reported questionnaires and with a case study population of 10 testers, which gave insight into the previous game experience of the tester for both digital games and virtual reality games, evaluating the discomfort for hardware on both the sensor and the virtual reality headset, as well as the game regarding usability, user experience, level of immersion, and the existence of motion sickness and its source. The results corroborate that the immersion of the game is good, which suggests that it will help with triggering the phobia. Full article
(This article belongs to the Special Issue Recent Advances in Metaverse and Computer Vision)
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40 pages, 12295 KiB  
Article
Method for Assessing the Influence of Phobic Stimuli in Virtual Simulators
by Artem Obukhov, Mikhail Krasnyanskiy, Andrey Volkov, Alexandra Nazarova, Daniil Teselkin, Kirill Patutin and Darya Zajceva
J. Imaging 2023, 9(10), 195; https://doi.org/10.3390/jimaging9100195 - 25 Sep 2023
Cited by 1 | Viewed by 1725
Abstract
In the organizing of professional training, the assessment of the trainee’s reaction and state in stressful situations is of great importance. Phobic reactions are a specific type of stress reaction that, however, is rarely taken into account when developing virtual simulators, and are [...] Read more.
In the organizing of professional training, the assessment of the trainee’s reaction and state in stressful situations is of great importance. Phobic reactions are a specific type of stress reaction that, however, is rarely taken into account when developing virtual simulators, and are a risk factor in the workplace. A method for evaluating the impact of various phobic stimuli on the quality of training is considered, which takes into account the time, accuracy, and speed of performing professional tasks, as well as the characteristics of electroencephalograms (the amplitude, power, coherence, Hurst exponent, and degree of interhemispheric asymmetry). To evaluate the impact of phobias during experimental research, participants in the experimental group performed exercises in different environments: under normal conditions and under the influence of acrophobic and arachnophobic stimuli. The participants were divided into subgroups using clustering algorithms and an expert neurologist. After that, a comparison of the subgroup metrics was carried out. The research conducted makes it possible to partially confirm our hypotheses about the negative impact of phobic effects on some participants in the experimental group. The relationship between the reaction to a phobia and the characteristics of brain activity was revealed, and the characteristics of the electroencephalogram signal were considered as the metrics for detecting a phobic reaction. Full article
(This article belongs to the Section Mixed, Augmented and Virtual Reality)
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31 pages, 8611 KiB  
Article
Immersive Phobia Therapy through Adaptive Virtual Reality and Biofeedback
by Alin Moldoveanu, Oana Mitruț, Nicolae Jinga, Cătălin Petrescu, Florica Moldoveanu, Victor Asavei, Ana Magdalena Anghel and Livia Petrescu
Appl. Sci. 2023, 13(18), 10365; https://doi.org/10.3390/app131810365 - 16 Sep 2023
Cited by 12 | Viewed by 5507
Abstract
Phobias are a type of anxiety disorder characterized by severe fear of objects and situations. In recent years, virtual reality exposure therapy has emerged as a safer and more convenient method of treating phobias, with the same rate of success as classical therapy, [...] Read more.
Phobias are a type of anxiety disorder characterized by severe fear of objects and situations. In recent years, virtual reality exposure therapy has emerged as a safer and more convenient method of treating phobias, with the same rate of success as classical therapy, the in vivo exposure to stimuli. Following extensive research concerning the available technologies and after studying the state of the art in the field, we developed the PhoVR (Phobia therapy through Virtual Reality) system during a 2-year long project that involved the participation of a technical university, a biology faculty, and an industry partner specialized in designing 3D applications. Our final prototype incorporates scenarios for acrophobia, claustrophobia, and fear of public speaking therapy, in which the user is required to perform gamified tasks and navigate virtual reality environments with biophysical data acquisition (electrodermal activity and heart rate), automatic anxiety level classification, biofeedback integrated into the scenes’ elements, the dynamic adaptation of the virtual environments, and relaxation techniques made available at any moment. The control panel is an application dedicated to psychotherapists for managing patients’ profiles and therapy sessions. The feedback obtained in a qualitative survey with subjects and psychotherapists who evaluated the prototype validated the system and provided suggestions for refinement. Full article
(This article belongs to the Special Issue Virtual/Augmented Reality and Its Applications)
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13 pages, 247 KiB  
Article
The Methodology of Psychological Clinical Intervention in School Settings: Case Studies with Students with Special Emotional and Educational Needs
by Agostino Carbone and Rossella Assante del Leccese
Educ. Sci. 2023, 13(5), 463; https://doi.org/10.3390/educsci13050463 - 30 Apr 2023
Cited by 4 | Viewed by 2895
Abstract
The school context, following an overall complexification of society, presents several situations in which it is necessary to build a transformative setting based on the suspension of educational action and the use of in-depth interpretations of divergent behaviors. Method: Two teachers with psychological [...] Read more.
The school context, following an overall complexification of society, presents several situations in which it is necessary to build a transformative setting based on the suspension of educational action and the use of in-depth interpretations of divergent behaviors. Method: Two teachers with psychological training present and discuss cases studies of psychological intervention based on the analysis of demand methodology. Results: The two case studies presented concern, respectively, a difficult inclusion of a foreign pupil in the classroom and a school phobia of a student before graduating. In both cases, the classes are reconceived as clinical settings thereby giving new meaning to the psycho-social relationships of the students. The teachers promoted an overcoming of critical events: in the first case the pupil reaches school inclusion in a short time; in the second case the pupil reaches the diploma. Conclusion: The method of psychological intervention is proposed as an innovative practice of negotiation of new emotional symbolic structures in which to reproduce a coexistence in the scholastic context. It therefore appears necessary to equip schools with professional skills in the analysis of demand in order to train teachers to recognize the emotional dimensions within the class context. Full article
(This article belongs to the Section Special and Inclusive Education)
13 pages, 1817 KiB  
Article
The Walls Are Closing In: Postural Responses to a Virtual Reality Claustrophobic Simulation
by Harish Chander, Hannah R. Freeman, Christopher M. Hill, Christopher R. Hudson, Sachini N. K. Kodithuwakku Arachchige, Alana J. Turner, J. Adam Jones and Adam C. Knight
Clin. Transl. Neurosci. 2022, 6(2), 15; https://doi.org/10.3390/ctn6020015 - 17 Jun 2022
Cited by 1 | Viewed by 3374
Abstract
Background: Changes in the visual environment and thereby, the spatial orientation, can induce postural instability leading to falls. Virtual reality (VR) has been used to expose individuals to virtual environments (VE) that increase postural threats. Claustrophobia is an anxiety disorder categorized under situational [...] Read more.
Background: Changes in the visual environment and thereby, the spatial orientation, can induce postural instability leading to falls. Virtual reality (VR) has been used to expose individuals to virtual environments (VE) that increase postural threats. Claustrophobia is an anxiety disorder categorized under situational phobias and can induce such postural threats in a VE. Purpose: The purpose of the study was to investigate if VR-generated claustrophobic simulation has any impact on postural threats that might lead to postural instability. Methods: Thirty healthy men and women (age: 20.7 ± 1.2 years; height: 166.5 ± 7.3 cm; mass: 71.7 ± 16.2 kg) were tested for postural stability while standing on a force platform, upon exposure to five different testing trials, including a normal stance (NoVR), in stationary VE (VR), and three consecutive, randomly initiated, unexpected claustrophobia trials (VR CP1, VR CP2, VR CP3). The claustrophobia trials involved all four walls closing in towards the center of the room. Center of pressure (COP)-derived postural sway variables were analyzed with a one-way repeated measures analysis of variance at an alpha level of 0.05. Results: Significant main effect differences existed in all but one dependent COP-derived postural sway variables, at p < 0.05. Post-hoc pairwise comparisons with a Bonferroni correction revealed that, predominantly, postural sway excursions were significantly lower in claustrophobia trials compared to NoVR and VR, but only accomplished with significantly increased sway velocity. Conclusion: The VR CP trials induced lower postural sway magnitude, but with increased velocity, suggesting a bracing and co-contraction strategy when exposed to virtual claustrophobic postural threats. Additionally, postural sway decreased with subsequent claustrophobia trials, suggesting potential motor learning effects. Findings from the study offer insights to postural control behavior under virtual claustrophobic simulations and can aid in VR exposure therapy for claustrophobia. Full article
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14 pages, 858 KiB  
Systematic Review
The Simulation Game—Virtual Reality Therapy for the Treatment of Social Anxiety Disorder: A Systematic Review
by Pasquale Caponnetto, Sergio Triscari, Marilena Maglia and Maria C. Quattropani
Int. J. Environ. Res. Public Health 2021, 18(24), 13209; https://doi.org/10.3390/ijerph182413209 - 15 Dec 2021
Cited by 35 | Viewed by 13912
Abstract
(1) Background: With the term Virtual reality (VR) we refer to a three-dimensional environment generated by the computer, in which subjects interact with the environment as if they were really inside it. The most used VR tools are the so-called HMD (head-mounted display) [...] Read more.
(1) Background: With the term Virtual reality (VR) we refer to a three-dimensional environment generated by the computer, in which subjects interact with the environment as if they were really inside it. The most used VR tools are the so-called HMD (head-mounted display) which make it possible to achieve what theorists define “direct mediated action”. The aim of our systematic review is specifically to investigate the applications of virtual reality therapy for the treatment of social anxiety disorder, also known as social phobia. The most common treatment for social anxiety disorder is represented by “in vivo exposure therapy” (iVET). This method consists of exposing the participant, in a gradual and controlled way, to anxious stimuli, with the goal to change the subject’s response to the object or situation that is causing the fear. However, the main flaw of “in Vivo therapies” is represented by both the huge costs involved and the possible disturbance variables that can hinder the execution of the therapeutic treatment. Virtual reality exposure therapy could therefore, if confirmed in its effectiveness, constitute a solution to eliminate these two defects demonstrated by “in vivo exposure therapy”. The goal is to use VR as a means for the clinician to build a tailor-made path for the participant in order to make him acquire “in virtual” those skills necessary for a good adaptation in the “real” world. (2) Methods: From February 2021 until the date of submission of the article (September 2021), we conducted a systematic review aiming to verify the effectiveness of virtual reality exposure therapy (VRET) for the treatment of SAD. (3) Results: We identified a total of 205 unique articles. Among these, 20 full-text articles were assessed for eligibility and 5 of these met the eligibility criteria and were, therefore, included in the final systematic review. (4) Conclusions: Virtual reality therapies proved to be a valid alternative to the acquisition of social skills suitable for improving the symptoms of SAD. Although there has not been a significant difference between VRET and iVET, the low costs and flexibility of VRET open up new scenarios for achieving greater psychophysical well-being. Full article
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19 pages, 1886 KiB  
Article
Repetitive and Inflexible Active Coping and Addiction-like Neuroplasticity in Stressed Mice of a Helplessness–Resistant Inbred Strain
by Simona Cabib, Paolo Campus, Emanuele Claudio Latagliata, Cristina Orsini and Valeria Tarmati
Behav. Sci. 2021, 11(12), 174; https://doi.org/10.3390/bs11120174 - 10 Dec 2021
Cited by 5 | Viewed by 3808
Abstract
Dysfunctional coping styles are involved in the development, persistence, and relapse of psychiatric diseases. Passive coping with stress challenges (helplessness) is most commonly used in animal models of dysfunctional coping, although active coping strategies are associated with generalized anxiety disorder, social anxiety disorder, [...] Read more.
Dysfunctional coping styles are involved in the development, persistence, and relapse of psychiatric diseases. Passive coping with stress challenges (helplessness) is most commonly used in animal models of dysfunctional coping, although active coping strategies are associated with generalized anxiety disorder, social anxiety disorder, panic, and phobias as well as obsessive-compulsive and post-traumatic stress disorder. This paper analyzes the development of dysfunctional active coping strategies of mice of the helplessness–resistant DBA/2J (D2) inbred strain, submitted to temporary reduction in food availability in an uncontrollable and unavoidable condition. The results indicate that food-restricted D2 mice developed a stereotyped form of food anticipatory activity and dysfunctional reactive coping in novel aversive contexts and acquired inflexible and perseverant escape strategies in novel stressful situations. The evaluation of FosB/DeltaFosB immunostaining in different brain areas of food-restricted D2 mice revealed a pattern of expression typically associated with behavioral sensitization to addictive drugs and compulsivity. These results support the conclusion that an active coping style represents an endophenotype of mental disturbances characterized by perseverant and inflexible behavior. Full article
(This article belongs to the Section Biological Psychiatry)
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13 pages, 272 KiB  
Article
Mental Imagery and Social Pain in Adolescents—Analysis of Imagery Characteristics and Perspective—A Pilot Study
by Susan Muriel Schwarz, Mersiha Feike and Ulrich Stangier
Children 2021, 8(12), 1160; https://doi.org/10.3390/children8121160 - 8 Dec 2021
Cited by 8 | Viewed by 3242
Abstract
Background: Mental imagery (MI) may play a key role in the development of various mental disorders in adolescents. Adolescence is known to be a fragile life period, in which acceptance by one’s favored peer group is extremely important, and social rejection is particularly [...] Read more.
Background: Mental imagery (MI) may play a key role in the development of various mental disorders in adolescents. Adolescence is known to be a fragile life period, in which acceptance by one’s favored peer group is extremely important, and social rejection is particularly painful. This is the first pilot study investigating MI and its relationship to social pain (SP). Method: A sample of 80 adolescents (14–20 years; 75.3% female) completed a web-based quasi-experimental design about the contents and characteristics of their spontaneous positive and negative MI and associated emotions, and were asked to complete the Social Pain Questionnaire, the Becks Depression Inventory and the Social Phobia Inventory. Results: A higher score of SP was significantly associated with increased fear, sadness, and feelings of guilt, and less control over negative MI. Characteristics of negative MI were more precisely predicted by SP scores than depression- and social anxiety scores. Adolescents with higher SP-scores more often reported negative images including social situations and were more likely to perceive negative images in a combination of field-and observer perspectives than adolescents with lower SP scores. Conclusion: SP-sensitivity seems to be linked to unique characteristics of negative MI, which reveals the strong emotional impact of social exclusion in youths. The results do not allow causal conclusions to be drawn, but raise questions about previous studies comparing each imagery perspective individually. Full article
(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)
11 pages, 690 KiB  
Article
Causes and Severity of Dentophobia in Polish Adults—A Questionnaire Study
by Dominika Furgała, Kinga Markowicz, Aleksandra Koczor-Rozmus and Anna Zawilska
Healthcare 2021, 9(7), 819; https://doi.org/10.3390/healthcare9070819 - 28 Jun 2021
Cited by 9 | Viewed by 4283
Abstract
Introduction: A phobia is defined as an irrational fear, the intensity of which is inadequate to the circumstances, and it leads to the avoidance of situations that trigger it. A person with dentophobia avoids dental treatment, even when the pain in the teeth [...] Read more.
Introduction: A phobia is defined as an irrational fear, the intensity of which is inadequate to the circumstances, and it leads to the avoidance of situations that trigger it. A person with dentophobia avoids dental treatment, even when the pain in the teeth or oral cavity exceeds their fear. Fear and anxiety are the most common emotional states experienced by patients in dental offices. The aim of the study was to determine the following: the probable causes of dentophobia, which procedures patients fear the most, and the subjective feeling of fear on a point scale. Materials and Methods: The research was conducted in the form of an anonymous online questionnaire and its printed equivalent. The survey was available from 23 January to 16 March 2020, and it was addressed to adult respondents. In total, 130 respondents and 102 dental students took part in the survey. Results: It is worthwhile emphasizing that the main reason for dentist visits (for almost one-third of men and almost one-fifth of women surveyed) is a toothache. Periodontal problems (2.2%), tooth extractions (1.8%), and prosthetic consultations (0.9%) were relatively rare reasons for the respondents to visit a dentist. The vast majority of respondents see the cause of dentophobia as being related to their previous bad experiences. The second most frequently chosen answer is anxiety, which is caused by the sounds of dental apparatus. Conclusions: Pain is the most common reason given for fear of visiting a dentist, as well as the cause of dentophobia. Pain reduction can positively affect the frequency of visits to a dentist, thus, improving the condition of the oral cavity of patients. Full article
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11 pages, 1079 KiB  
Review
Cognitive Neural Mechanism of Social Anxiety Disorder: A Meta-Analysis Based on fMRI Studies
by Xianglian Yu, Yijun Ruan, Yawen Zhang, Jiayi Wang, Yuting Liu, Jibiao Zhang and Lin Zhang
Int. J. Environ. Res. Public Health 2021, 18(11), 5556; https://doi.org/10.3390/ijerph18115556 - 22 May 2021
Cited by 7 | Viewed by 6644
Abstract
Objective: The present meta-analysis aimed to explore the cognitive and neural mechanism of social anxiety disorder (SAD) from a whole-brain view, and compare the differences in brain activations under different task paradigms. Methods: We searched Web of Science Core Collection and other databases [...] Read more.
Objective: The present meta-analysis aimed to explore the cognitive and neural mechanism of social anxiety disorder (SAD) from a whole-brain view, and compare the differences in brain activations under different task paradigms. Methods: We searched Web of Science Core Collection and other databases with the keywords related to social anxiety, social phobia, and functional magnetic resonance imaging (fMRI) for comparing persons with SAD to healthy controls and used the activation likelihood estimation method. Thirty-seven papers met the inclusion criteria, including 15 with emotional faces as stimuli, 8 presenting specific situations as stimuli, and 14 using other types of tasks as stimuli. Among these papers, 654 participants were in the SAD group and 594 participants were in the control group with 335 activation increase points and 115 activation decrease points. Results: Whole-brain analysis showed that compared with healthy controls, persons with SAD showed significantly lower activation of the left anterior cingulate gyrus (MNI coordinate: x = −6, y = 22, z = 38; p 0.001). Sub-group analysis based on task indicated that when performing tasks with emotional faces as stimuli, persons with SAD showed significantly lower activation of the left cerebellar slope and fusiform gyrus (MNI coordinate: x = −26, y = −68, z = −12; p 0.001), and significantly higher activation of the right supramarginal gyrus and angular gyrus, than healthy controls (MNI coordinate: x = 58, y = −52, z = 30; p 0.001). Conclusion: Individuals with social anxiety disorder show abnormal activation in the cingulate gyrus, which is responsible for the process of attention control, and task type can influence the activation pattern. Full article
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16 pages, 1914 KiB  
Article
The Associations between Imageability of Positive and Negative Valence Words and Fear Reactivity
by Bindiya Lakshmi Raghunath, Claudio Mulatti, Michelle Jin-Yee Neoh, Marc H. Bornstein and Gianluca Esposito
Psychiatry Int. 2021, 2(1), 32-47; https://doi.org/10.3390/psychiatryint2010003 - 9 Feb 2021
Cited by 1 | Viewed by 3580
Abstract
This study investigated the associations of imageability with fear reactivity. Imageability ratings of four word classes: positive and negative (i) emotional and (ii) propriosensitive, neutral and negative (iii) theoretical and (iv) neutral concrete filler, and fear reactivity scores—degree of fearfulness towards different situations [...] Read more.
This study investigated the associations of imageability with fear reactivity. Imageability ratings of four word classes: positive and negative (i) emotional and (ii) propriosensitive, neutral and negative (iii) theoretical and (iv) neutral concrete filler, and fear reactivity scores—degree of fearfulness towards different situations (Total Fear (TF) score) and total number of extreme fears and phobias (Extreme Fear (EF) score), were obtained from 171 participants. Correlations between imageability, TF and EF scores were tested to analyze how word categories and their valence were associated with fear reactivity. Imageability ratings were submitted to recursive partitioning. Participants with high TF and EF scores had higher imageability for negative emotional and negative theoretical words. The correlations between imageability of negative emotional words and negative theoretical words for EF score were significant. Males showed stronger correlations for imageability of negative emotional words for EF and TF scores. High imageability for positive emotional words was associated with lower fear reactivity in females. These findings were discussed with regard to negative attentional bias theory of anxiety, influence on emotional systems, and gender-specific coping styles. This study provides insight into cognitive functions involved in mental imagery, semantic competence for mental imagery in relation to fear reactivity, and a potential psycholinguistic instrument assessing fear reactivity. Full article
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25 pages, 3408 KiB  
Article
Tourism Impacts, Tourism-Phobia and Gentrification in Historic Centers: The Cases of Málaga (Spain) and Gdansk (Poland)
by Fernando Almeida-García, Rafael Cortés-Macías and Krzysztof Parzych
Sustainability 2021, 13(1), 408; https://doi.org/10.3390/su13010408 - 5 Jan 2021
Cited by 52 | Viewed by 11561
Abstract
This study analyzes the role of residents in urban tourist destinations affected by the increase in tourist flows, which have generated various problems such as tourism, gentrification and the emergence of tourism as a threat to residents. The role of residents in tourist [...] Read more.
This study analyzes the role of residents in urban tourist destinations affected by the increase in tourist flows, which have generated various problems such as tourism, gentrification and the emergence of tourism as a threat to residents. The role of residents in tourist destinations has not been analyzed regularly during the development process of destinations. We study two cases of historic centers in European cities, with the aim of comparing tourism problems, which are common to most European urban destinations. This study was conducted by administering surveys amongst residents of these historic centers (378 in Málaga, Spain, and 380 in Gdansk, Poland). These cities show a similar demographic size and urban characteristics. This is the first comparative research on tourism-phobia and gentrification in destinations, a field of analysis that is still not studied much. We develop specific scales to measure gentrification and tourism-phobia; moreover, we study the impact of some tourist problems that affect residents (noise, dirt, occupation of public spaces, etc.), and we show the spatial distribution of tourism-phobia. The same analysis instruments are used for both cities. The results of this study show that the tourism-phobia situation is different in the analyzed destinations. It is more intense in the case of Málaga than in Gdansk. The two historic centers are especially affected by the processes of increased tourist flows and the growth of new forms of tourist accommodation. The research results show that the residents’ annoyance caused by tourism gentrification is more intense than tourism-phobia. Both case studies highlight the residents’ complaints regarding the inadequate management of problems by public stakeholders and control measures. Full article
(This article belongs to the Special Issue Overtourism in Historic Cities)
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19 pages, 622 KiB  
Review
Nomophobia: An Individual’s Growing Fear of Being without a Smartphone—A Systematic Literature Review
by Antonio-Manuel Rodríguez-García, Antonio-José Moreno-Guerrero and Jesús López Belmonte
Int. J. Environ. Res. Public Health 2020, 17(2), 580; https://doi.org/10.3390/ijerph17020580 - 16 Jan 2020
Cited by 172 | Viewed by 37541
Abstract
This review examines the current literature focused on nomophobia (objectives, methodological design, main variables, sample details, and measurement methods) in the Scopus and Web of Science databases. To this end, we conducted a systematic literature review in accordance with the Preferred Reporting Items [...] Read more.
This review examines the current literature focused on nomophobia (objectives, methodological design, main variables, sample details, and measurement methods) in the Scopus and Web of Science databases. To this end, we conducted a systematic literature review in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. The initial sample consisted of 142 articles, of which 42 met the inclusion criteria and were analyzed in detail. The findings show that the current research is in an exploratory phase, with a greater predominance of descriptive, nonexperimental, and cross-sectional studies that explore the prevalence of nomophobia mainly in adolescents and university students. The most widely used measurement instrument is the Nomophobia Questionnaire (NMP-Q) proposed by Yildrim and Correia. In addition, the research suggests that nomophobia negatively affects personality, self-esteem, anxiety, stress, academic performance, and other physical and mental health problems. We are therefore faced with a health problem, which negatively affects a person, causing psychological problems and physical and behavioral changes. Full article
(This article belongs to the Special Issue Psychosocial Impacts of New Technologies and the Internet)
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