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A proposal for including nomophobia in the new DSM-V

Open access
Bragazzi, Nicola, Del Puente, Giovanni·2014·Psychology Research and Behavior Management
DOI 10.2147/prbm.s41386PMC PMC4036142
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Abstract

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is considered to be the gold standard manual for assessing the psychiatric diseases and is currently in its fourth version (DSM-IV), while a fifth (DSM-V) has just been released in May 2013. The DSM-V Anxiety Work Group has put forward recommendations to modify the criteria for diagnosing specific phobias. In this manuscript, we propose to consider the inclusion of nomophobia in the DSM-V, and we make a comprehensive overview of the existing literature, discussing the clinical relevance of this pathology, its epidemiological features, the available psychometric scales, and the proposed treatment. Even though nomophobia has not been included in the DSM-V, much more attention is paid to the psychopathological effects of the new media, and the interest in this topic will increase in the near future, together with the attention and caution not to hypercodify as pathological normal behaviors.

AI snapshot

Written from the paper’s full text.

TL;DR

This narrative proposal argues that nomophobia—pathological anxiety or discomfort from being out of contact with a mobile phone or computer—should be considered for inclusion in the DSM-V. It reviews clinical features, epidemiology, psychometric scales, comorbidity, and treatment, while cautioning against over-pathologizing normal behavior.

Key findings

  • Nomophobia is described as a contemporary digital-society disorder involving anxiety, nervousness, or anguish when out of contact with a mobile phone or computer; clinical features include compulsive phone use, carrying a charger, avoiding places where phone use is banned, “ringxiety,” sleeping with the phone, preferring technology-mediated communication, and phone-related debt or expense.
  • Reported epidemiological figures include more than 13 million British people affected, about 53% of mobile users (48% women, 58% men); a SecurEnvoy survey found women more worried about losing their mobile devices (70%) than men (61%); 77% of youngsters/adolescents reported anxiety about being without their phone; and the Helsinki Institute for Information Technology found people check phones on average 34 times a day.
  • Many psychometric scales exist, including QDMP/TMPD (38 Likert items; reliability 0.85–0.91), MPPUS (27 Likert items; Cronbach’s alpha >0.90 in all subscales), MPDQ (20 Likert questions; alpha 0.86), MPAI (17 Likert items; coefficient >0.90 in all subscales), and COS (23 items; self-consistence 0.87).
  • Treatment evidence is limited: cognitive-behavioral psychotherapy is suggested but randomized trials are lacking; one reported case was treated with tranylcypromine 20 mg/day increased to 40 mg/day plus clonazepam 0.5 mg/day, later replaced by clonazepam 1 mg/day alone for 2 months.

Methods

  • Design: a proposal and comprehensive narrative overview of existing literature, not an empirical study or systematic review.
  • Data/sample: no primary sample or dataset; the paper cites prior surveys, clinical cases, psychometric validation studies, and treatment reports.
  • Analysis: narrative synthesis of clinical relevance, epidemiological features, psychological predictors, comorbidity, available psychometric scales, and proposed treatments.

Limitations

  • Stated by the paper: nomophobia was not included in the DSM-V; further research is needed for a standardized and operational definition; randomized trials for cognitive-behavioral psychotherapy are lacking; the link between new technologies and psychopathological impact remains unclear; double diagnosis and comorbidity issues remain open; and caution is needed to avoid nosologomania and hypercodifying normal behaviors as pathological.
  • Evident from the text: the review relies partly on media or non-peer-reviewed survey figures (e.g., a Daily Mail URL and SecurEnvoy survey) and does not describe a systematic search strategy or formal quality appraisal.
  • Evident from the text: no primary diagnostic validation data are presented to support inclusion of nomophobia as a DSM diagnosis.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.2147/prbm.s41386

Cites

66 of 66 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 43 cited sources checked · 0 supported · 0 flagged

  • Premisecitation

    The most important psychological predictors of impulsive mobile device use are personality, emotional intelligence, social skills, adjustment abilities, self-esteem, smoking, alcohol and drug consumption, other psychopathologies in comorbidity, gender, and socioeconomic status.

    “The most important psychological predictors are: personality, emotional intelligence (self-regulation of affective status), social skills, adjustment abilities, self-esteem, smoking, alcohol and drug consumption, other psychopathologies in comorbidity, besides the gender and the socioeconomic status.”
    Quote in the paperNot a substantial claim0 of 7 sources checked
    • cites [55] Ezoe S Toda M Yoshimura K Naritomi A Den R Morimoto K Relationships of personality and lifestyle with mobile phone dependence among female nursing students Soc Behav Pers 2009 37 2 231 238

      Not checked in the free run.

    • cites [56] Black DW Belsare G Schlosser S Clinical features, psychiatric comorbidity, and health-related quality of life in persons reporting compulsive computer use behavior J Clin Psychiatry 1999 60 839 844 10665630

      Not checked in the free run.

    • cites [57] Hong FY Chiu SI Huang DH A model of the relationship between psychological characteristics, mobile phone addiction and use of mobile phones by Taiwanese university female students Comput Hum Behav 2012 28 6 2152

      Not checked in the free run.

    • cites [58] Walsh SP White KM Cox S Young RM Keeping in constant touch: The predictors of young Australians’ mobile phone involvement Comput Hum Behav 2011 27 1 333 342

      Not checked in the free run.

    • cites [59] Sánchez-Martínez M Otero A Factors associated with cell phone use in adolescents in the community of Madrid (Spain) Cyberpsychol Behav 2009 12 2 131 137 19072078

      Not checked in the free run.

    • cites [60] Bataller SA Tratamiento de un caso crónico de adicción a Internet. [Treatment of a chronic case of Internet addiction] Cuadernos de Medicina Psicosomática y Psiquiatría de Enlace 2006 79/80 71 88 Spanish

      Not checked in the free run.

    • cites [61] Clay S Social Software and the Politics of Groups Networks, Economics, and Culture mailing list 3 6 2003

      Not checked in the free run.

  • Premisecitation

    Many surveys in different countries and cultures have confirmed that nomophobia is universally widespread and present.

    “Moreover, many other surveys performed in different countries and cultures – from the USA to India,34 from Europe (Spain, Poland, and Finland, for example)35–37 to Japan38 –have confirmed these findings and shown that nomophobia is universally widespread and present.”
    Quote in the paperNot a substantial claim0 of 5 sources checked
    • cites [34] Dixit S Shukla H Bhagwat A Bindal A Goyal A Zaidi AK Shrivastava A A study to evaluate mobile phone dependence among students of a medical college and associated hospital of central India Indian J Community Med 2010 35 2 339 341 20922119 PMC2940198

      Not checked in the free run.

    • cites [35] Oksman V Turtiainen J Mobile communication as a social stage. The meanings of mobile communication among teenagers in Finland N Med Soc 2004 6 319 339

      Not checked in the free run.

    • cites [36] Krajewska-Kułak E Kułak W Stryzhak A Szpakow A Prokopowicz W Marcinkowski JT Problematic mobile phone using among the Polish and Belarusian University students, a comparative study Prog Health Sci 2012 2 1 45 50

      Not checked in the free run.

    • cites [37] Chóliz M Mobile Phone Addiction in Adolescence: Evaluation and Prevention of Mobile Addiction in Teenagers Saarbrücken Lambert Academic Publishing 2010

      Not checked in the free run.

    • cites [38] Toda M Monden K Kubo K Morimoto K Mobile phone dependence and health-related life-style of university students Soc Behav Pers 2006 34 1277 1284

      Not checked in the free run.

  • Premisecitation

    Nomophobia often co-occurs with other psychiatric disorders, including anxiety and panic disorder, other phobias, obsessive-compulsive disorder, eating disorders, depression, dysthymia, alcohol and drug addiction, other behavioral addictions, and personality disorders.

    “Like other psychiatric diseases, an important issue of nomophobia is comorbidity: some scholars talk about a double diagnosis, since often pathologies tend to cluster together, like anxiety and panic disorder, other forms of phobia (and in particular social phobia or social phobia disorder), obsessive-compulsive disorder, eating disorders, depression and dysthymia, alcohol and drug addiction, as w”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [39] Kamibeppu K Sugiura H Impact of the mobile phone on junior hightschool students’ friends hips in the Tokyo metropolitan area Cyberpsychol Behav 2005 8 2 121 130 15938651

      Not checked in the free run.

  • Premisecitation

    Validated psychometric scales for nomophobia exist, such as QDMP/TMPD, PMPUQ, PDMP, MPPUS, PMPUS, EBAM, CERM/QERMP, STDS, MPDQ, MAT, MPAI, COS, EMUPM, ECPUS, TMG, and MPIQ.

    “Even though the topic is very recent, there are some validated psychometric scales, such as Questionnaire of Dependence of Mobile Phone/Test of Mobile Phone Dependence (QDMP/TMPD),40,41 Problematic Mobile Phone Use Questionnaire (PMPUQ), Perceived Dependence on the Mobile Phone (PDMP),33 Mobile Phone Problem Use Scale (MPPUS),42 Problematic Mobile Phone Use Scale (PMPUS),43 Escala breve para evalu”
    Quote in the paperNot a substantial claim0 of 4 sources checked
    • cites [40] Chóliz M Villanueva V Questionnaire of Dependence of Mobile Phone: Psychometric Properties and Gender Differences 11th European Congress of Psychology Oslo July 7–10, 2009

      Not checked in the free run.

    • cites [41] Chóliz M Villanueva V Chóliz MC Ellas, ellos y su móvil: Uso, abuso (¿y dependencia?) del teléfono móvil en la adolescencia. [They (males and females) and their mobile: use, abuse (and addiction?) to mobile in adolescence.] Revista Española de Drogodependencias 2009 34 74 88 Spanish

      Not checked in the free run.

    • cites [33] Billieux J Van der Linden M Rochat L The role of impulsivity in actual and problematic use of the mobile phone Appl Cogn Psychol 2008 22 9

      Not checked in the free run.

    • cites [42] Bianchi A Phillips JG Psychological predictors of problem mobile phone use Cyberpsychol Behav 2005 8 39 51 15738692

      Not checked in the free run.

  • Premisecitation

    King et al. successfully treated a patient suffering from nomophobia with tranylcypromine 20 mg/day (gradually increased up to 40 mg/day) plus clonazepam 0.5 mg/day.

    “King et al27 successfully treated a patient suffering from nomophobia with tranylcypromine 20 mg/day (gradually increased up to 40 mg/day) plus clonazepam 0.5 mg/day.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [27] Kuss DJ Griffiths MD Online social networking and addiction – a review of the psychological literature Int J Environ Res Public Health 2011 8 9 3528 3552 22016701 PMC3194102

      Not checked in the free run.

  • May combine two claims. 2
  • Classified as probably not a substantial claim. 8

  • May combine two claims.

    Premisecitation

    Bianchi and Phillips found that psychological predictors of problematic mobile use may be younger age, self-negative views, low esteem and self-efficacy, and dysregulated arousal.

    “Bianchi and Phillips42 have found that psychological predictors of problematic mobile use may be: younger age, self-negative views, low esteem and self-efficacy, a dysregulated arousal (such as in high extroversion or in introversion).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [42] Bianchi A Phillips JG Psychological predictors of problem mobile phone use Cyberpsychol Behav 2005 8 39 51 15738692

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    More than 13 million British people suffer from nomophobia, about 53% of mobile users (48% women, 58% men).

    “According to a survey performed by Stewart Fox-Mills, more than 13 million British people suffer from nomophobia, about 53% of mobile users (48% women, 58% men) (http://www.dailymail.co.uk/news/article-550610/Nomophobia-fear-mobile-phone-contact--plague-24-7-age.html).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Stewart Fox-Mills

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The Helsinki Institute for Information Technology found that, on average, people check their phones 34 times a day.

    “Other surveys carried out independently have found similar results, while the Helsinki Institute for Information Technology has found that, on average, people check their phones 34 times a day.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Helsinki Institute for Information Technology

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    According to a SecurEnvoy survey, women are more worried about losing their mobile devices (70%) than men (61%).

    “According to a recent survey carried out by SecurEnvoy, women are more worried about losing their mobile devices (70%) than are men (61%).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites SecurEnvoy

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Premisecitation

    Nomophobia is a disorder of the contemporary digital and virtual society, characterized by discomfort, anxiety, nervousness or anguish caused by being out of contact with a mobile phone or computer.

    “Nomophobia is considered a disorder of the contemporary digital and virtual society and refers to discomfort, anxiety, nervousness or anguish caused by being out of contact with a mobile phone or computer.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [26] King AL Valença AM Nardi AE Nomophobia: the mobile phone in panic disorder with agoraphobia: reducing phobias or worsening of dependence Cogn Behav Neurol 2010 23 1 52 54 20299865

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Mobile phone-based interventions are a useful medical aid.

    “It is undeniable that technology through new social media, social network sites, social informatics, and “social software” (an expression coined by Clay Shirky)61 enables us to perform our job more quickly and with efficiency, and it is also true that mobile phone-based interventions are a useful medical aid.62–64”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [62] Marsch LA Dallery J Advances in the psychosocial treatment of addiction: the role of technology in the delivery of evidence-based psychosocial treatment Psychiatr Clin North Am 2012 35 2 481 493 22640767 PMC3362794

      Not checked in the free run.

    • cites [63] Free C Knight R Robertson S Smoking cessation support delivered via mobile phone text messaging (txt2stop): a single-blind, randomised trial Lancet 2011 378 9785 49 55 21722952 PMC3143315

      Not checked in the free run.

    • cites [64] Cadle BA Rasmus KC Varela JA Cellular phone-based image acquisition and quantitative ratiometric method for detecting cocaine and benzoylecgonine for biological and forensic applications Subst Abuse 2010 4 21 33 22879741 PMC3411535

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Models of psychological predictors of an impulsive use of mobile devices are available.

    “Moreover, models of psychological predictors of an impulsive use of mobile devices are also available.55–61”
    Quote in the paperNot a substantial claim0 of 7 sources checked
    • cites [55] Ezoe S Toda M Yoshimura K Naritomi A Den R Morimoto K Relationships of personality and lifestyle with mobile phone dependence among female nursing students Soc Behav Pers 2009 37 2 231 238

      Not checked in the free run.

    • cites [56] Black DW Belsare G Schlosser S Clinical features, psychiatric comorbidity, and health-related quality of life in persons reporting compulsive computer use behavior J Clin Psychiatry 1999 60 839 844 10665630

      Not checked in the free run.

    • cites [57] Hong FY Chiu SI Huang DH A model of the relationship between psychological characteristics, mobile phone addiction and use of mobile phones by Taiwanese university female students Comput Hum Behav 2012 28 6 2152

      Not checked in the free run.

    • cites [58] Walsh SP White KM Cox S Young RM Keeping in constant touch: The predictors of young Australians’ mobile phone involvement Comput Hum Behav 2011 27 1 333 342

      Not checked in the free run.

    • cites [59] Sánchez-Martínez M Otero A Factors associated with cell phone use in adolescents in the community of Madrid (Spain) Cyberpsychol Behav 2009 12 2 131 137 19072078

      Not checked in the free run.

    • cites [60] Bataller SA Tratamiento de un caso crónico de adicción a Internet. [Treatment of a chronic case of Internet addiction] Cuadernos de Medicina Psicosomática y Psiquiatría de Enlace 2006 79/80 71 88 Spanish

      Not checked in the free run.

    • cites [61] Clay S Social Software and the Politics of Groups Networks, Economics, and Culture mailing list 3 6 2003

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The DSM-V Anxiety Work Group has put forward recommendations to modify the criteria for diagnosing specific phobias.

    “Currently these diagnostic criteria are under review, and new recommendations to ameliorate the definition have been put forward by the DSM-V Anxiety Work Group.3”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3] LeBeau RT Glenn D Liao B Specific phobia: a review of DSM-IV specific phobia and preliminary recommendations for DSM-V Depress Anxiety 2010 27 148 167 20099272

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    The increasing utilization and penetration of new technological devices and virtual communication are causing changes in individuals' daily habits and behaviors, as well as in identity and in the common ways of perceiving reality.

    “The increasing utilization and penetration of new technological devices and virtual communication involving personal computers and tablets – the so-called computer-mediated communication – and mobile phones (such as smartphones) are causing changes in individuals’ daily habits and behaviors, as well as in identity and in the common ways of perceiving reality,8 creating personal languages and j”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [8] Handy C Waiting for the mountain to move: and other reflections on life London Arrow 1992

      Not checked in the free run.

    • cites [9] Green J Language: intrtxtlty Crit Q 2007 49 124 128

      Not checked in the free run.

    • cites [10] Rheingold H 1993 The Virtual Community: Homesteading on the Electronic Frontier New York Harper Perennial

      Not checked in the free run.

9 of 9

  • The paper relies on this without support.

    Nomophobia has not been included in the DSM-V.

    “Even though nomophobia has not been included in the DSM-V, much more attention is paid to the psychopathological effects of the new media, and the interest in this topic will increase in the near future, together with the attention and caution not to hypercodify as pathological normal behaviors.”

  • The paper relies on this without support.

    Youngsters and adolescents are more likely to experience nomophobia; 77% have reported anxiety and worries about being without their phone.

    “Youngsters and adolescents are more likely to experience nomophobia; 77% have reported having anxiety and worries about being without their phone, followed by the 25–34-year age group and those over 55 years.”

  • The paper relies on this without support.

    Indian psychiatrists found a threefold increase in psychopathology related to problematic mobile use in the last few years.

    “Nomophobia has been described by Indian psychiatrists, who found a threefold increase in psychopathology related to problematic mobile use in the last few years.”

  • The paper relies on this without support.

    Randomized trials of cognitive-behavioral psychotherapy for nomophobia are currently lacking.

    “However, cognitive-behavioral psychotherapy has been suggested as an effective treatment for nomophobia, even though randomized trials are currently lacking.”

  • The paper relies on this without support.

    The link between new technologies and their psychopathological impact is still unclear.

    “Since the link between new technologies and their psychopathological impact is still unclear, further research in the field is needed.”
5 of 5

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Nomophobia may be a contributing factor to SNS addiction by facilitating and enhancing repeated SNS use, forming habits that increase vulnerability to addiction-related symptoms.

    “Accordingly, nomophobia can lead to using the mobile phone in an impulsive way [85], and may thus be a contributing factor to SNS addiction as it can facilitate and enhance the repeated use of social networking sites, forming habits that may increase the general vulnerability for the experience of addiction-related symptoms as a consequence of problematic SNS use.”

    From Social networking sites and addiction: Ten lessons learned (2017) · cites this paper as [85]

  • Mobile phone use is understood to lead to alterations in everyday life habits and perceptions of reality, associated with negative outcomes including impaired social interactions, social isolation, and somatic and mental health problems.

    “Using mobile phones is understood as leading to alterations in everyday life habits and perceptions of reality, which can be associated with negative outcomes, such as impaired social interactions, social isolation, as well as both somatic and mental health problems, including anxiety, depression, and stress [85,87].”

    From Social networking sites and addiction: Ten lessons learned (2017) · cites this paper as [85]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • DSM described as both current fourth edition and already released fifth edition

    Minor

    The abstract calls DSM-IV the current version while stating that DSM-V has already been released. Both claims are presented as current at the time of writing.

  • King et al treatment report cites the wrong numbered reference

    Minor

    The treatment paragraph attributes the report to King et al and cites reference 27, but reference 27 is by Kuss and Griffiths. The King et al paper is listed as reference 26.

2 of 2

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. [1]American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR) Washington, DC American Psychiatric Association 2000
  2. [11]Castells M The Rise of the Network Society 2nd ed Oxford Blackwell 2001

Cited by

Sorted by citations

Related

Authors
Bragazzi, N., & Del Puente, G.
Affiliations
University of Genoa (IT)
Corresponding author
Bragazzi, Nicola
ORCID
Bragazzi, Nicola
Venue
Psychology Research and Behavior Management
Publisher
Informa UK Limited
Published
2014-05
Volume
7
Pages
155
ISSN
1179-1578 (ISSN-L)
DOI
10.2147/prbm.s41386
PMC
PMC4036142
OpenAlex
W2023549485
Semantic Scholar
b6ddb9f41e13879921fbbf92c5f5935af05966e3
Cited by
615
References
66
Citations by year
2026: 60 · 2025: 73 · 2024: 61 · 2023: 88 · 2022: 79 · 2021: 59 · 2020: 68 · 2019: 49 · 2018: 32 · 2017: 26 · 2016: 9 · 2015: 11
FWCI
46.45
Type
journal article
Language
en
Open access
Licence
Locations
  • Psychology Research and Behavior Management (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
  • CINECA IRIS Institutial Research Information System (University of Genoa) (submittedVersion)
Topics
  • Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
Keywords
nomophobia, DSM-V, psychiatric diagnosis, specific phobia, anxiety disorders, new media, smartphone addiction, psychometric scale, treatment

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