Nomophobic behaviours among students in a selected college of higher education in Anekal Taluk, Bengaluru Urban District - A mixed-methods study

Nomophobic behaviours among students in a selected college of higher education in Anekal Taluk, Bengaluru Urban District - A mixed-methods study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Nomophobic behaviours among students in a selected college of higher education in Anekal Taluk, Bengaluru Urban District - A mixed-methods study Thomson C Davis, Nancy Angeline Gnanaselvam, Pretesh Rohan Kiran, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6828290/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 23 Nov, 2025 Read the published version in Discover Public Health → Version 1 posted 11 You are reading this latest preprint version Abstract Introduction: Nomophobia, the fear of being without a mobile phone or unable to use it due to no signal or low battery, is increasingly common among college students due to growing smartphone reliance. This study evaluates the prevalence, associated factors, and perceptions of nomophobic behaviors and smartphone use among students in a professional education college in Anekal Taluk, Bangalore, using a mixed-methods approach. Methods: A cross-sectional study was conducted with 436 students using a validated questionnaire capturing socio-demographic details, smartphone usage, and the Nomophobia Questionnaire (NMP-Q). Focus group discussions (FGDs) with students and key informant interviews (KIIs) with professors and psychiatrists explored attitudes and experiences. Quantitative data were analyzed using SPSS V 21.0 with chi-square tests and logistic regression, while qualitative data underwent thematic inductive analysis. Results: Participants had a mean age of 19.09 ± 1.27 years, with 57.6% male. Nomophobia prevalence was 19% mild, 61% moderate, and 19% severe. Significant associations linked nomophobic behaviors to phone ownership (p=0.012) and reduced concentration from overuse (p<0.000). Qualitative findings highlighted themes of health impacts, academic influence, recreational dynamics, and daily life integration. Discussion: Moderate nomophobia was highly prevalent, despite students’ awareness of excessive phone use risks. Associations with smartphone ownership and usage patterns underscore the need for health education and institutional policies to address adverse effects on students’ well-being. Conclusion: Moderate nomophobia predominates among Bangalore college students. Interventions promoting awareness and encouraging social and physical activities are recommended to mitigate nomophobic behaviors. Nomophobia (NMP) Smartphone Usage Mobile Phone Addictions Prevalence Behavioural Addictions Mixed-methods study Figures Figure 1 INTRODUCTION Smartphones are highly popular among the youth, with college students often being early adopters of new technology [ 1 ]. Technological advancements and the decreasing cost of smartphones have led to a rise in global mobile phone dependence. By the end of 2023, almost 70% of the world’s population were smartphone users[ 2 ]. In India, the total number of internet subscribers increased from 824.29 million at the end of Mar 2022 to 881.25 million by the end of March 2023, reflecting a yearly growth rate of 6.83%, according to the Telecom Regulatory Authority of India (TRAI 2023 report) [ 3 ]. Smartphones have become indispensable in everyday life, offering a wide range of applications for information, communication, education, and entertainment. A smartphone is defined as a mobile phone with a touch screen, mobile internet access via Wi-Fi or cellular networks, the capability to install applications, and additional functions such as media players, digital cameras, and GPS-based navigation[ 4 ]. While smartphones offer numerous benefits, excessive use can lead to various problems[ 5 ]. It has been documented that low-energy electromagnetic radiation (EMR) received during mobile phone use can cause structural and functional cellular changes, leading to abnormal cell responses within the Central Nervous System (CNS) and the auditory system[ 6 ]. The mental health implications of uncontrolled and extreme mobile phone use are significant, with various studies linking excessive use to loneliness, depressive symptoms, interpersonal anxiety, poor self-control, low self-sufficiency, and low self-esteem[ 7 ]. Nomophobia (NMP) is defined as the irrational fear of being without a mobile phone or being unable to use it due to reasons such as lack of signal or low battery[ 8 ]. The term is a portmanteau of "NO MOBILE PHONE PHOBIA." NMP is considered a disorder of the 21st century[ 9 ]. Although not yet included in the current DSM-5, it has been recommended as a “specific phobia” based on definitions given in the DSM-IV[ 10 ]. Many nomophobics experience “Rinxiety” (a portmanteau of ring and anxiety), also known as “Phantom Vibration Syndrome” or phantom ringing, which is the false sensation of the phone ringing. NMP significantly affects the mental status of mobile phone users[ 11 ]. The “over-connection syndrome” refers to the reduction in direct interactions due to excessive mobile phone use. The term “techno-stress” describes individuals who avoid direct interactions by engaging in isolation, often leading to mood disorders such as depression[ 12 ]. Given the increasing prevalence of smartphone use and its potential negative effects on mental health, this study was undertaken to investigate NMP and its associated factors among college students and to explore the perceptions, attitudes, and lived experiences related to smartphone use and nomophobia through qualitative inquiry. This research aims to fill the gap in existing literature, particularly in the context of Karnataka. METHODOLOGY A mixed methodology was adopted to explore nomophobia (NMP) and its associated factors among students at a professional education college in Anekal Taluk, Bangalore both quantitatively and qualitatively using a Sequential Explanatory research design, conducted in two-phase where the quantitative data was collected first (cross-sectional design), followed by the generation of qualitative data (explorative design). The selected college is a private institution with students from adequate socio-economic backgrounds and good academic records. The study included all students enrolled at the college, except those absent on the day of data collection. Ethical Approval: Institutional Ethics Committee approval was obtained from St. John’s Medical College (IEC Ref No: 224/2020). All methods were carried out in accordance with relevant guidelines and regulations, including the ethical standards of the institutional research committee. All children aged less than 18 years gave assent to participate in the study and their parents’ consent was obtained. All participants aged 18 years and above gave written informed consent to participate in the study. Permission to conduct the study was obtained from the Block Education Officer and the University Principal. Sample Size and Sampling Technique: Based on an estimated NMP prevalence of 73% from a previous study conducted among medical students in Indore, India[11], the required sample size was calculated to be 302 students, using an absolute precision of 5% at a 95% confidence level. Accounting for a potential nonresponse rate of 10%, the sample size was increased to 350. Universal sampling was applied across all departments, resulting in a final sample size of 436 students. Data Collection: Data were collected using a validated, structured questionnaire that comprised three sections: socio-demographic characteristics, smartphone usage patterns, and the NMP Questionnaire (NMP-Q). The NMP-Q, developed by Yildirim and Correia in 2015[11][13], consists of 20 items addressing four factors of NMP: inability to communicate, loss of connectedness, inability to access information, and giving up convenience. Responses were rated on a 7-point Likert scale ranging from 1 (strongly disagree) to 7 (strongly agree). Quantitative Data Analysis: Quantitative data were entered into Microsoft Excel 2017 and analyzed using SPSS version 21.0. Descriptive statistics, including percentages, means, and standard deviations, were calculated for frequency distribution. The associations between various demographic factors and NMP were examined using chi-square tests and logistic regression analysis. Qualitative Data Collection and Analysis: For the qualitative component, four Focus Group Discussions (FGDs) were conducted with students, and five Key Informant Interviews (KIIs) were held with college faculty and a psychiatrist. The FGDs and KIIs explored themes related to health, academics, recreation, and daily life impacts of smartphone use. The qualitative data were analyzed using thematic inductive analysis to identify key themes and sub-themes. This comprehensive mixed-methods approach provided a robust understanding of NMP prevalence and its associated factors among college students, combining quantitative data with in-depth qualitative insights. RESULTS A total of 436 subjects participated in the study, aged between 17 and 25 years, with a mean age of 19.09 ± 1.27 years. The sample comprised 57.6% males, and a significant portion (42.2%) belonged to the upper socioeconomic status, as classified by the Modified BG Prasad 2023 scale (Table 1). Hostel residents were less prevalent (34.4%) compared to day scholars. An overwhelming majority (96.1%) owned their own phone, and 92% had internet-enabled smartphones. Over half of the participants (50.5%) reported experiencing a lack of concentration due to excessive phone use. Furthermore, nearly three-fourths (68.1%) carried phone chargers to campus, and 64.9% reported checking their phones more than 20 times a day, with a mean frequency of 2.549 ± 5.210 times per hour. Approximately one-fifth (19.3%) of the students were categorized as severely nomophobic, while 61.2% were moderately nomophobic (Table 2). Significant associations were found between NMP and factors such as lack of concentration due to phone overuse and owning a phone (Table 3) Focus group discussions highlighted key themes including health impact, academic influence, recreational dynamics, and everyday life integrations. Subthemes under health encompassed the impact of smartphones on the body and mind, perceptions and realities on how students perceive the effects of smartphones on their health, and social well-being indicating the influence of smartphone use on social interactions and relationships(Fig 1). A psychiatrist, serving as a key informant, stated, “Nomophobia can lead to cognitive repercussions such as inability to concentrate and stereotypical behavior, along with affective repercussions like irritability and sleep disorders.” Despite the consensus on the health hazards of continuous phone use, such as digital eye strain, headaches, reduced physical activity, musculoskeletal disorders (e.g., neck pain), and sleep disturbances, some participants acknowledged the benefits of smartphones in fitness tracking and accessing health-related information. Psychological issues due to smartphones cited by the participants were lack of attention, sleep disturbances, anxiety, depression, and behavioral disorders. According to the participants, health information available online is often misguiding, and this is clear from the verbatim state of one of the respondents- “I mostly use Google to find answers to my health-related questions and it even tells me what medicines I should take !” (Student participant, FGD 2). Relationship problems, communal tension, breach of privacy, false information, crimes, and pornography were other listed social health problems. “My grandmother is 82, and she complains that all of us are so busy with our phones that we rarely have quality family time!” (Student participant, FGD 2) reflects on the relationship problems faced by students. Subthemes identified under the main theme of academic influence were information hubs (smartphones acting as gateways to knowledge and learning resources), digital forums specifying the role of smartphones in fostering academic discussions and collaborations, storage (smartphones as repositories for educational content and materials) and productivity. “I depend on Google more than books because it saves me a lot of time and energy, especially in exams.....!” (Student participant, FGD 3) reflects on the dependence on smartphones to access information, a cardinal feature of NMP. According to a faculty, “I have often noticed that the students who use mobile phones consecutively during class hours, few of them tend to perform poorly in internals and term exams” , reflecting that smartphone usage decreases productivity and distracts the students from academic activities. Relationships, the social media world, multimedia, and gaming realms were the subthemes under the theme recreational dynamics of smartphones. The interviews revealed that connectedness was a driving force for young adults to use a smartphone which is itself a feature of NMP. Many believed that smartphones had both positive impacts such as increased connectivity as well as negative impacts which are highlighted in this verbatim from FGD 4 “ When I returned home for the previous Christmas my father was busy in a conference call, my mother was texting on WhatsApp and my brother was playing PubG, then only I realized how dependent our lives had become”. In the fourth theme of day-to-day activities, subthemes that arose are about how much impact smartphones have on communication, trade, accounting, and emergency services. One of the dimensions of NMP which is giving up convenience that the smartphones provide is very well evident under this theme. When describing the use of his smartphone, one of the participants from FGD 1 said “ my smartphone use has probably been excessive. I mean just because it is so convenient, I mean you have literally everything you need in your pocket. If I didn’t have to type research papers or play FIFA, I probably wouldn’t need a laptop. It is just convenient; you always have everything you need right there…”. One of the other salient features of NMP is not being able to communicate without a smartphone which is expressed very well by a student in FGD 5, “It lets me keep in touch with…like my parents who live abroad. We can text or talk all day or just message each other as needed. For work and stuff, if someone has a question for me I can respond to them wherever I am and this power of mine is taken away from me when I don’t have a smartphone..” DISCUSSION In the current scenario, learning and socialization have been revolutionized by social media, internet, gaming, and smartphone usage. The impact of excessive screen time includes obesity, sleep disturbance, postural and visual problems, cognitive issues, body image and emotional disorders, drug and substance use disorders. Use of media and internet can enhance learning for youth, promote positive emotions and moral values. However, the duration of screen time should be restricted. Our study did not study the type of content and sites viewed by youth. However, much of the content available online nowadays is filled with violence, risk-taking behaviours such as unsafe sex, driving, alcohol, tobacco use, unsafe stunts, sexual content, negative stereotypes, bullying, trolling, inaccurate content regarding health, wrong advertisements, and pornography[14]. In our study, 62.9% of the youth were found to be moderately nomophobic which is similar to a study done by Sethia et al among the undergraduate students of a medical college in Bhopal, where it was 61.5%[13]. A study done by Jilisha et al among college students in Pondicherry also found that the prevalence of moderate NMP is 54.5%[15]. These similar findings suggest that adolescents and youth are more prone to nomophobic behaviors which might have been due to the cultural similarities in the study settings where parental supervision and social etiquette play a major role. The brain of adolescents and Youth is growing constantly and the prefrontal cortex which is involved in impulse control doesn’t develop completely till the person reaches around mid-20 years. The emotional processing and reward-seeking areas might have been developed in the limbic system earlier, however, risk-taking will continue resulting in youth seeking instantly rewarding and stimulating activities without worrying about any of the risks involved. This makes them much more vulnerable to addiction. An increased probability of staying away from home for education, results in loss of parental control and also contributes to the increased use of social networking and the need to make calls in order to stay connected to friends and family. DSM 5 has included NMP as a specific phobia that can mimic behavioral disorders(9). The high prevalence of nomophobia indicates that youth might not be spending adequate time outdoors in physical activity, sleep, family and friends interaction, focus on education, and skills development. This would mean that the holistic development of adolescents and youth might be negatively impacted. As per the International Classification of Diseases-11, Mental, Behavioural or Neurodevelopmental Disorders Section, a new category called disorders due to addictive behaviours that includes gaming disorder has been added to a new diagnosis. In such individuals, the addiction affects life interests and daily activities. This addiction can result in affecting personal life, family life, socialisation, educational achievements, and work in youth. This can also result in aggressive behaviours, depression, physical inactivity, sleep deprivation, unhealthy diet, visual, hearing issues[16]. The factors derived in the present study, i.e., connectedness, access to information, staying updated, relieving boredom, convenience, etc., are similar to the themes of a Turkish study by Caglar Yildirim (12), such as the inability to communicate, inconvenience, and information accessibility. Fullwood et al.[17] categorized users based on their perception of use. There was mention of participants thinking that smartphones are very important for accessing information and for staying in touch with their friends and family, which were similar to the results obtained in the current study. The similarity in these findings shows a constant pattern of NMP in other parts of the world Youth can use various educational platforms such as Youtube, Wikipedia and Google for learning support. However, there is no clear guidelines on the duration of screen time which is healthy for adolescents and youth[18]. Social media such as Instagram makes youth create an ideal online image which can lead to more stress, and an addiction pathway can be created since they would strive to receive likes and comments. This can stem from low self-esteem and the constant need to seek external validation. While viewing curated content online, youth can further suffer from more self-esteem resulting in a high risk of anxiety and depression. Social media platforms are created with a plan of variable reward system which increases use among youth and this in turn creates a dopamine-driven feedback loop while engaging with other users and the interface online. So overtime, the young user can continue to obsessively check online and spend more time with social media despite the negative consequences. Families might be taking measures to prevent excess and compulsive screen time. However, one should understand that adolescent parenting itself has its own challenges and along with it disciplining without understanding the youth fully, will not be rewarding. In our study area, most of the parents are working in unorganised sectors in which they will be overworked and underpaid, resulting in the inability to spend quality and quantity time with their children. This could also impact the holistic development of youth and utilisation of their full potential. One of the limitations of this study could be that since the study assessed deviant behavior, there might have been a chance of the social desirability bias. Students might not have wanted to reveal their original smartphone usage pattern to the investigator and could have written what was ideally expected from them. More such studies in larger populations of students may be needed to observe if patterns are constant in other settings. From the health systems perspective, our study area is served in the community by community Health workers such as ASHA and the clinical services are provided by Anekal Taluk Hospital. As per the National Health Mission, ASHA workers can use Patient Health Questionnaire-2 to screen for mental illnesses in the community. The Taluk hospital has once in a month satellite Mental Health Clinic called Manochaitanya conducted as a part of the District Mental Health Programme, through Psychiatrists from National Institute of Mental Health And Neurological Sciences (NIMHANS). Patients diagnosed with mental illnesses in the community are referred to this clinic in Taluk Hospital for further management[19]. However, stigma is high and most families do not want to seek care due to stigma and try to manage at home informally. To ensure Universal Health Coverage, we have to provide health education, life skills impartation and community level screening of common mental illnesses through the community health workers and refer for appropriate care. Adolescent mental health and youth wellbeing is to be strengthened in the RMNCAH+N strategy and the Kishori Sakthi Yojana. In the Rashtriya Bal Swasthya Karyakram, screening for mental illnesses such as depression and addiction is not included. Integrating mental health into these strategies will address the primary prevention of nomophobia. CONCLUSION Most of the students (62.9%) were found to be moderately nomphobic. Students who had their own phones and those who felt that they had a lack of concentration due to overuse of phones were found to be positively associated with nomophobic behaviors. Most of them are aware of the harmful effects of excessive phone use. This study provided greater insight into nomophobia and enhanced our understanding of the phenomenon by identifying the dimensions of nomophobia as described by these college students. Because smartphones have become an integral part of classrooms and have been extensively used as instructional technology, it is of great importance for educators to consider the unintended consequences and implications of smartphones in regard to teaching and learning. RECOMMENDATION: Health education regarding the physical and mental health effects of excessive mobile phone usage should be done among school children, college students, and parents . Also, inclusion of extra and co-curricular activities in higher education that encourage socializing such as physical activity, Yoga, and meditation will be beneficial . Colleges should implement strict rules against the usage of phones during academic hours Declarations Funding: None Conflict of interest: None declared Clinical Trial Registration: Not applicable. This study is a cross-sectional mixed-methods study and does not meet the criteria for a clinical trial. Consent to Participate: All participants provided written informed consent prior to participation in the study, including the questionnaire, focus group discussions, and key informant interviews. The study was approved by the Institutional Ethics Committee of St John’s Medical College & Research Institute, Bangalore Consent to Publish: Not applicable. No identifiable data or materials requiring consent for publication are included in this manuscript. References S. Lee, “Examining the factors that influence early adopters’ smartphone adoption: The case of college students,” Telemat. Informatics , vol. 31, pp. 308–318, May 2014, doi: 10.1016/j.tele.2013.06.001. 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Tables Table 1: Baseline Demography Categories N (%) Mean ± Sd Age <20 Years 278 (63.8) 19.099 ± 1.272 Years ≥20 Years 158 (36.2) Gender Males 251(57.6) Females 185(42.4) Number Of Members In Family ≤ 4 287(65.9) 4.667 ± 2.730 ≥ 5 149(34.1) Socio Economic Status * (Modified BG Prasad scale 2023) Upper 184(42.2) Upper Middle 169(38.8) Middle 57(13.1) Lower Middle 23(5.3) Lower 3(0.7) Residents of Hostel Yes 150(34.4) No 286(65.6) Own a phone of your own Yes 419(96.1) No 17(3.9) Internet activated Yes 401(92) No 35(8) Lack of concentration Yes 216(49.5) No 220(50.5) Phone checks per hour 2.549 ± 5.210 Carrying phone charger to college Yes 139(31.9) No 297(68.1) Check phone more than 20 times a day Yes 283(64.9) No 153(35.1) Table 2: Nomophobia categories N% No NMP 2(0.5) Mild NMP 83(19) Moderate NMP 267(61.2) Severe NMP 84(19.3) Table 3: Associations with NMP NMP Category Lack of concentration Chi-Square Value P value YES (%) NO (%) No NMP 0 (0) 2(0.4) 19.372* <0.000 Mild NMP 36(8.25) 47(10.77) Moderate NMP 121(27.55) 146(33.48) Severe NMP 59(13.53) 25(5.73) Total 216(49.5) 220(50.4) People owning a phone of their own No NMP Mild NMP Moderate NMP Severe NMP Chi-Square Value P Value Yes 1(0.2) 77(18.3) 261(62.29) 80(19.0) 10.679** 0.012 No 1(5.8) 6(35.2) 6(35.2) 4(23.5) *Fisher's Exact **Pearson’s Chi Square Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 23 Nov, 2025 Read the published version in Discover Public Health → Version 1 posted Editorial decision: Revision requested 19 Sep, 2025 Reviews received at journal 06 Sep, 2025 Reviewers agreed at journal 06 Sep, 2025 Reviews received at journal 25 Aug, 2025 Reviewers agreed at journal 14 Aug, 2025 Reviews received at journal 24 Jul, 2025 Reviewers agreed at journal 19 Jul, 2025 Reviewers invited by journal 18 Jul, 2025 Editor assigned by journal 03 Jul, 2025 Submission checks completed at journal 28 Jun, 2025 First submitted to journal 28 Jun, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6828290","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":487953750,"identity":"de7a41a0-405d-415c-b2b0-6a2c95ebef85","order_by":0,"name":"Thomson C Davis","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABCUlEQVRIiWNgGAWjYDCCA2DEkADhVdjIgQUfENZiANVyJs0YLJhAQAsDXAtj2+HEBgaEpVgB3/Ezhgd/MPzJ4xc7/vBxARtz+vywww+BttjJ6TZg1yJ5JsfgMA+DQbHk7Bxj4xk8bLkbb6cZALUkG5sdwK7F4EBawmEglbjhdg6bNI8ET+7G2QkgLQcSt+HScv5ZAtBhIC3pz6R5DCTSDWenf8Cv5UbygQM8YC0JZtI8CQYJ8tI5+G2RvPH4wGEeA+PEmSC/8BxIMNwgnVNwIMEAt1/4zic2f/xRIZfYL53+8DHvv//y8rPTN3/4UGEnh0sL1HkoAYIuQhDIN5CiehSMglEwCkYCAAB4sGY3qchQGwAAAABJRU5ErkJggg==","orcid":"","institution":"Jubilee Mission Medical College and Research Institute","correspondingAuthor":true,"prefix":"","firstName":"Thomson","middleName":"C","lastName":"Davis","suffix":""},{"id":487953751,"identity":"11cfef84-1f8d-4f6f-a4ab-f709edd1d703","order_by":1,"name":"Nancy Angeline Gnanaselvam","email":"","orcid":"","institution":"St. John’s Medical College","correspondingAuthor":false,"prefix":"","firstName":"Nancy","middleName":"Angeline","lastName":"Gnanaselvam","suffix":""},{"id":487953752,"identity":"bd7eb587-35d1-42c2-92b0-79c771078a96","order_by":2,"name":"Pretesh Rohan Kiran","email":"","orcid":"","institution":"St. John’s Medical College","correspondingAuthor":false,"prefix":"","firstName":"Pretesh","middleName":"Rohan","lastName":"Kiran","suffix":""},{"id":487953753,"identity":"888d8c34-afed-4ad3-86be-6651ce86f981","order_by":3,"name":"John Stephen","email":"","orcid":"","institution":"St. John’s Medical College","correspondingAuthor":false,"prefix":"","firstName":"John","middleName":"","lastName":"Stephen","suffix":""},{"id":487953754,"identity":"96540839-ba85-4924-b45d-31074e1366c9","order_by":4,"name":"Abhishek Patil","email":"","orcid":"","institution":"St. John’s Medical College","correspondingAuthor":false,"prefix":"","firstName":"Abhishek","middleName":"","lastName":"Patil","suffix":""}],"badges":[],"createdAt":"2025-06-05 10:38:24","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6828290/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6828290/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12982-025-01142-z","type":"published","date":"2025-11-23T15:59:16+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":87347669,"identity":"289fa621-c4d0-4f83-95c4-34fd7ee2314f","added_by":"auto","created_at":"2025-07-23 02:40:29","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":56097,"visible":true,"origin":"","legend":"\u003cp\u003eThematic framework prepared after analysis using inductive codes\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-6828290/v1/f3ca8dc18316a205d5d82c15.png"},{"id":96650974,"identity":"e6683c2e-2eb0-44eb-a3e2-857c9c0d6e1b","added_by":"auto","created_at":"2025-11-24 16:13:12","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":488714,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6828290/v1/30de0cf5-8921-4829-8c15-b89a5c4c73b9.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Nomophobic behaviours among students in a selected college of higher education in Anekal Taluk, Bengaluru Urban District - A mixed-methods study","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eSmartphones are highly popular among the youth, with college students often being early adopters of new technology [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Technological advancements and the decreasing cost of smartphones have led to a rise in global mobile phone dependence. By the end of 2023, almost 70% of the world\u0026rsquo;s population were smartphone users[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. In India, the total number of internet subscribers increased from 824.29\u0026nbsp;million at the end of Mar 2022 to 881.25\u0026nbsp;million by the end of March 2023, reflecting a yearly growth rate of 6.83%, according to the Telecom Regulatory Authority of India (TRAI 2023 report) [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Smartphones have become indispensable in everyday life, offering a wide range of applications for information, communication, education, and entertainment. A smartphone is defined as a mobile phone with a touch screen, mobile internet access via Wi-Fi or cellular networks, the capability to install applications, and additional functions such as media players, digital cameras, and GPS-based navigation[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eWhile smartphones offer numerous benefits, excessive use can lead to various problems[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. It has been documented that low-energy electromagnetic radiation (EMR) received during mobile phone use can cause structural and functional cellular changes, leading to abnormal cell responses within the Central Nervous System (CNS) and the auditory system[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. The mental health implications of uncontrolled and extreme mobile phone use are significant, with various studies linking excessive use to loneliness, depressive symptoms, interpersonal anxiety, poor self-control, low self-sufficiency, and low self-esteem[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eNomophobia (NMP) is defined as the irrational fear of being without a mobile phone or being unable to use it due to reasons such as lack of signal or low battery[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. The term is a portmanteau of \"NO MOBILE PHONE PHOBIA.\" NMP is considered a disorder of the 21st century[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Although not yet included in the current DSM-5, it has been recommended as a \u0026ldquo;specific phobia\u0026rdquo; based on definitions given in the DSM-IV[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Many nomophobics experience \u0026ldquo;Rinxiety\u0026rdquo; (a portmanteau of ring and anxiety), also known as \u0026ldquo;Phantom Vibration Syndrome\u0026rdquo; or phantom ringing, which is the false sensation of the phone ringing. NMP significantly affects the mental status of mobile phone users[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. The \u0026ldquo;over-connection syndrome\u0026rdquo; refers to the reduction in direct interactions due to excessive mobile phone use. The term \u0026ldquo;techno-stress\u0026rdquo; describes individuals who avoid direct interactions by engaging in isolation, often leading to mood disorders such as depression[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eGiven the increasing prevalence of smartphone use and its potential negative effects on mental health, this study was undertaken to investigate NMP and its associated factors among college students and to explore the perceptions, attitudes, and lived experiences related to smartphone use and nomophobia through qualitative inquiry. This research aims to fill the gap in existing literature, particularly in the context of Karnataka.\u003c/p\u003e"},{"header":"METHODOLOGY","content":"\u003cp\u003eA mixed methodology was adopted to explore nomophobia (NMP) and its associated factors among students at a professional education college in Anekal Taluk, Bangalore both quantitatively and qualitatively using a Sequential Explanatory research design, conducted in two-phase where the quantitative data was collected first (cross-sectional design), followed by the generation of qualitative data (explorative design). The selected college is a private institution with students from adequate socio-economic backgrounds and good academic records. The study included all students enrolled at the college, except those absent on the day of data collection.\u003c/p\u003e\n\u003cp\u003eEthical Approval:\u003c/p\u003e\n\u003cp\u003eInstitutional Ethics Committee approval was obtained from St. John\u0026rsquo;s Medical College (IEC Ref No: 224/2020). All methods were carried out in accordance with relevant guidelines and regulations, including the ethical standards of the institutional research committee. All children aged less than 18 years gave assent to participate in the study and their parents\u0026rsquo; consent was obtained. All participants aged 18 years and above gave written informed consent to participate in the study. Permission to conduct the study was obtained from the Block Education Officer and the University Principal.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSample Size and Sampling Technique:\u003c/p\u003e\n\u003cp\u003eBased on an estimated NMP prevalence of 73% from a previous study conducted among medical students in Indore, India[11], the required sample size was calculated to be 302 students, using an absolute precision of 5% at a 95% confidence level. Accounting for a potential nonresponse rate of 10%, the sample size was increased to 350. Universal sampling was applied across all departments, resulting in a final sample size of 436 students.\u003c/p\u003e\n\u003cp\u003eData Collection:\u003c/p\u003e\n\u003cp\u003eData were collected using a validated, structured questionnaire that comprised three sections: socio-demographic characteristics, smartphone usage patterns, and the NMP Questionnaire (NMP-Q). The NMP-Q, developed by Yildirim and Correia in 2015[11][13], consists of 20 items addressing four factors of NMP: inability to communicate, loss of connectedness, inability to access information, and giving up convenience. Responses were rated on a 7-point Likert scale ranging from 1 (strongly disagree) to 7 (strongly agree).\u003c/p\u003e\n\u003cp\u003eQuantitative Data Analysis:\u003c/p\u003e\n\u003cp\u003eQuantitative data were entered into Microsoft Excel 2017 and analyzed using SPSS version 21.0. Descriptive statistics, including percentages, means, and standard deviations, were calculated for frequency distribution. The associations between various demographic factors and NMP were examined using chi-square tests and logistic regression analysis.\u003c/p\u003e\n\u003cp\u003eQualitative Data Collection and Analysis:\u003c/p\u003e\n\u003cp\u003eFor the qualitative component, four Focus Group Discussions (FGDs) were conducted with students, and five Key Informant Interviews (KIIs) were held with college faculty and a psychiatrist. The FGDs and KIIs explored themes related to health, academics, recreation, and daily life impacts of smartphone use. The qualitative data were analyzed using thematic inductive analysis to identify key themes and sub-themes.\u003c/p\u003e\n\u003cp\u003eThis comprehensive mixed-methods approach provided a robust understanding of NMP prevalence and its associated factors among college students, combining quantitative data with in-depth qualitative insights.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003eA total of 436 subjects participated in the study, aged between 17 and 25 years, with a mean age of 19.09 \u0026plusmn; 1.27 years. The sample comprised 57.6% males, and a significant portion (42.2%) belonged to the upper socioeconomic status, as classified by the Modified BG Prasad 2023 scale (Table 1). Hostel residents were less prevalent (34.4%) compared to day scholars. An overwhelming majority (96.1%) owned their own phone, and 92% had internet-enabled smartphones. Over half of the participants (50.5%) reported experiencing a lack of concentration due to excessive phone use. Furthermore, nearly three-fourths (68.1%) carried phone chargers to campus, and 64.9% reported checking their phones more than 20 times a day, with a mean frequency of 2.549 \u0026plusmn; 5.210 times per hour. Approximately one-fifth (19.3%) of the students were categorized as severely nomophobic, while 61.2% were moderately nomophobic (Table 2). Significant associations were found between NMP and factors such as lack of concentration due to phone overuse and owning a phone (Table 3)\u003c/p\u003e\n\u003cp\u003eFocus group discussions highlighted key themes including health impact, academic influence, recreational dynamics, and everyday life integrations. Subthemes under health encompassed the impact of smartphones on the body and mind, perceptions and realities on how students perceive the effects of smartphones on their health, and social well-being indicating the influence of smartphone use on social interactions and relationships(Fig 1). A psychiatrist, serving as a key informant, stated, \u003cem\u003e\u0026ldquo;Nomophobia can lead to cognitive repercussions such as inability to concentrate and stereotypical behavior, along with affective repercussions like irritability and sleep disorders.\u0026rdquo;\u003c/em\u003e Despite the consensus on the health hazards of continuous phone use, such as digital eye strain, headaches, reduced physical activity, musculoskeletal disorders (e.g., neck pain), and sleep disturbances, some participants acknowledged the benefits of smartphones in fitness tracking and accessing health-related information.\u003c/p\u003e\n\u003cp\u003ePsychological issues due to smartphones cited by the participants were lack of attention, sleep disturbances, anxiety, depression, and behavioral disorders. According to the participants, health information available online is often misguiding, and this is clear from the verbatim state of one of the respondents- \u003cem\u003e\u0026ldquo;I mostly use Google to find answers to my health-related questions and it even tells me what medicines I should take\u003c/em\u003e!\u0026rdquo; (Student participant, FGD 2). Relationship problems, communal tension, breach of privacy, false information, crimes, and pornography were other listed social health problems. \u003cem\u003e\u0026ldquo;My grandmother is 82, and she complains that all of us are so busy with our phones that we rarely have quality family time!\u0026rdquo;\u003c/em\u003e(Student participant, FGD 2) reflects on the relationship problems faced by students. Subthemes identified under the main theme of academic influence were information hubs (smartphones acting as gateways to knowledge and learning resources), digital forums specifying the role of smartphones in fostering academic discussions and collaborations, storage (smartphones as repositories for educational content and materials) and productivity. \u003cem\u003e\u0026ldquo;I depend on Google more than books because it saves me a lot of time and energy, especially in exams.....!\u0026rdquo;\u003c/em\u003e(Student participant, FGD 3) reflects on the dependence on smartphones to access information, a cardinal feature of NMP. According to a faculty, \u003cem\u003e\u0026ldquo;I have often noticed that the students who use mobile phones consecutively during class hours, few of them tend to perform poorly in internals and term exams\u0026rdquo;\u003c/em\u003e, reflecting that smartphone usage decreases productivity and distracts the students from academic activities.\u003c/p\u003e\n\u003cp\u003eRelationships, the social media world, multimedia, and gaming realms were the subthemes under the theme recreational dynamics of smartphones. The interviews revealed that connectedness was a driving force for young adults to use a smartphone which is itself a feature of NMP. Many believed that smartphones had both positive impacts such as increased connectivity as well as negative impacts which are highlighted in this verbatim from FGD 4\u003cem\u003e\u0026ldquo; When I returned home for the previous Christmas my father was busy in a conference call, my mother was texting on WhatsApp and my brother was playing PubG, then only I realized how dependent our lives had become\u0026rdquo;.\u0026nbsp;\u003c/em\u003eIn the fourth theme of day-to-day activities, subthemes that arose are about how much impact smartphones have on communication, trade, accounting, and emergency services. One of the dimensions of NMP which is giving up convenience that the smartphones provide is very well evident under this theme. When describing the use of his smartphone, one of the participants from FGD 1 said \u0026ldquo;\u003cem\u003emy smartphone use has probably been excessive. I mean just because it is so convenient, I mean you have literally everything you need in your pocket. If I didn\u0026rsquo;t have to type research papers or play FIFA, I probably wouldn\u0026rsquo;t need a laptop. It is just convenient; you always have everything you need right there\u0026hellip;\u0026rdquo;.\u003c/em\u003eOne of the other salient features of NMP is not being able to communicate without a smartphone which is expressed very well by a student in FGD 5, \u003cem\u003e\u0026ldquo;It lets me keep in touch with\u0026hellip;like my parents who live abroad. We can text or talk all day or just message each other as needed. For work and stuff, if someone has a question for me I can respond to them wherever I am and this power of mine is taken away from me when I don\u0026rsquo;t have a smartphone..\u0026rdquo;\u003c/em\u003e\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eIn the current scenario, learning and socialization have been revolutionized by social media, internet, gaming, and smartphone usage. The impact of excessive screen time includes obesity, sleep disturbance, postural and visual problems, cognitive issues, body image and emotional disorders, drug and substance use disorders. Use of media and internet can enhance learning for youth, promote positive emotions and moral values. However, the duration of screen time should be restricted. Our study did not study the type of content and sites viewed by youth. However, much of the content available online nowadays is filled with violence, risk-taking behaviours such as unsafe sex, driving, alcohol, tobacco use, unsafe stunts, sexual content, negative stereotypes, bullying, trolling, inaccurate content regarding health, wrong advertisements, and pornography[14]. In our study, 62.9% of the youth were found to be moderately nomophobic which is similar to a study done by Sethia et al among the undergraduate students of a medical college in Bhopal, \u0026nbsp;where it was 61.5%[13]. A study done by Jilisha et al among college students in Pondicherry also found that the prevalence of moderate NMP is 54.5%[15]. These similar findings suggest that adolescents and youth are more prone to nomophobic behaviors which might have been due to the cultural similarities in the study settings where parental supervision and social etiquette play a major role.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe brain of adolescents and Youth is growing constantly and the prefrontal cortex which is involved in impulse control doesn’t develop completely till the person reaches around mid-20 years. The emotional processing and reward-seeking areas might have been developed in the limbic system earlier, however, risk-taking will continue resulting in youth seeking instantly rewarding and stimulating activities without worrying about any of the risks involved. This makes them much more vulnerable to addiction.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAn increased probability of staying away from home for education, results in loss of parental control and also contributes to the increased use of social networking and the need to make calls in order to stay connected to friends and family. DSM 5 has included NMP as a specific phobia that can mimic behavioral disorders(9). The high prevalence of nomophobia indicates that youth might not be spending adequate time outdoors in physical activity, sleep, family and friends interaction, focus on education, and skills development. This would mean that the holistic development of adolescents and youth might be negatively impacted. As per the International Classification of Diseases-11, Mental, Behavioural or Neurodevelopmental Disorders Section, a new category called disorders due to addictive behaviours that includes gaming disorder has been added to a new diagnosis. In such individuals, the addiction affects life interests and daily activities. This addiction can result in affecting personal life, family life, socialisation, educational achievements, and work in youth. This can also result in aggressive behaviours, depression, physical inactivity, sleep deprivation, unhealthy diet, visual, hearing issues[16].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe factors derived in the present study, i.e., connectedness, access to information, staying updated, relieving boredom, convenience, etc., are similar to the themes of a Turkish study by Caglar Yildirim (12), such as the inability to communicate, inconvenience, and information accessibility. Fullwood et al.[17] categorized users based on their perception of use. There was mention of participants thinking that smartphones are very important for accessing information and for staying in touch with their friends and family, which were similar to the results obtained in the current study. The similarity in these findings shows a constant pattern of NMP in other parts of the world\u003c/p\u003e\n\u003cp\u003eYouth can use various educational platforms such as Youtube, Wikipedia and Google for learning support. However, there is no clear guidelines on the duration of screen time which is healthy for adolescents and youth[18]. Social media such as Instagram makes youth create an ideal online image which can lead to more stress, and an addiction pathway can be created since they would strive to receive likes and comments. This can stem from low self-esteem and the constant need to seek external validation. While viewing curated content online, youth can further suffer from more self-esteem resulting in a high risk of anxiety and depression. Social media platforms are created with a plan of variable reward system which increases use among youth and this in turn creates a dopamine-driven feedback loop while engaging with other users and the interface online. So overtime, the young user can continue to obsessively check online and spend more time with social media despite the negative consequences. Families might be taking measures to prevent excess and compulsive screen time. However, one should understand that adolescent parenting itself has its own challenges and along with it disciplining without understanding the youth fully, will not be rewarding. In our study area, most of the parents are working in unorganised sectors in which they will be overworked and underpaid, resulting in the inability to spend quality and quantity time with their children. This could also impact the holistic development of youth and utilisation of their full potential.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOne of the limitations of this study could be that since the study assessed deviant behavior, there might have been a chance of the social desirability bias. Students might not have wanted to reveal their original smartphone usage pattern to the investigator and could have written what was ideally expected from them. More such studies in larger populations of students may be needed to observe if patterns are constant in other settings.\u003c/p\u003e\n\u003cp\u003eFrom the health systems perspective, our study area is served in the community by community Health workers such as ASHA and the clinical services are provided by Anekal Taluk Hospital. As per the National Health Mission, ASHA workers can use Patient Health Questionnaire-2 to screen for mental illnesses in the community. The Taluk hospital has once in a month satellite Mental Health Clinic called Manochaitanya conducted as a part of the District Mental Health Programme, through Psychiatrists from National Institute of Mental Health And Neurological Sciences (NIMHANS). Patients diagnosed with mental illnesses in the community are referred to this clinic in Taluk Hospital for further management[19]. However, stigma is high and most families do not want to seek care due to stigma and try to manage at home informally. To ensure Universal Health Coverage, we have to provide health education, life skills impartation and community level screening of common mental illnesses through the community health workers and refer for appropriate care. Adolescent mental health and youth wellbeing is to be strengthened in the RMNCAH+N strategy and the Kishori Sakthi Yojana. In the Rashtriya Bal Swasthya Karyakram, screening for mental illnesses such as depression and addiction is not included. Integrating mental health into these strategies will address the primary prevention of nomophobia.\u0026nbsp;\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eMost of the students (62.9%) were found to be moderately nomphobic. Students who had their own phones and those who felt that they had a lack of concentration due to overuse of phones were found to be positively associated with nomophobic behaviors. Most of them are aware of the harmful effects of excessive phone use. This study provided greater insight into nomophobia and enhanced our understanding of the phenomenon by identifying the dimensions of nomophobia as described by these college students. Because smartphones have become an integral part of classrooms and have been extensively used as instructional technology, it is of great importance for educators to consider the unintended consequences and implications of smartphones in regard to teaching and learning.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRECOMMENDATION:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHealth education regarding the physical and mental health effects of excessive mobile phone usage should be done among school children, college students, and parents\u003cstrong\u003e.\u0026nbsp;\u003c/strong\u003eAlso, inclusion of extra and co-curricular activities in higher education that encourage socializing such as physical activity, Yoga, and meditation will be beneficial\u003cstrong\u003e.\u0026nbsp;\u003c/strong\u003eColleges should implement strict rules against the usage of phones during academic hours\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cem\u003eFunding: None\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eConflict of interest: None declared\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eClinical Trial Registration: Not applicable. This study is a cross-sectional mixed-methods study and does not meet the criteria for a clinical trial.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eConsent to Participate: All participants provided written informed consent prior to participation in the study, including the questionnaire, focus group discussions, and key informant interviews. The study was approved by the Institutional Ethics Committee of St John’s Medical College \u0026amp; Research Institute, Bangalore\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eConsent to Publish: Not applicable. No identifiable data or materials requiring consent for publication are included in this manuscript.\u003c/em\u003e\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eS. Lee, \u0026ldquo;Examining the factors that influence early adopters\u0026rsquo; smartphone adoption: The case of college students,\u0026rdquo; \u003cem\u003eTelemat. Informatics\u003c/em\u003e, vol. 31, pp. 308\u0026ndash;318, May 2014, doi: 10.1016/j.tele.2013.06.001.\u003c/li\u003e\n\u003cli\u003eStatista [Internet]., \u0026ldquo;Number of smartphone users worldwide 2014-2020,\u0026rdquo; [Online]. Available: https://www.statista.com/statistics/330695/number-of-smartphone-users-worldwide.\u003c/li\u003e\n\u003cli\u003eT. 2023, \u0026ldquo;\u0026lsquo;Yearly TelecomServices Performance IndicatorReport\u0026rsquo; for the Year, 2022-23,\u0026rdquo; no. 79, pp. 11\u0026ndash;13, 2023, [Online]. Available: https://www.trai.gov.in/sites/default/files/PR_No.12of2024.pdf.\u003c/li\u003e\n\u003cli\u003eS. Haug, R. P. Castro, M. Kwon, A. Filler, T. Kowatsch, and M. P. Schaub, \u0026ldquo;Smartphone use and smartphone addiction among young people in Switzerland,\u0026rdquo; \u003cem\u003eJ. Behav. Addict.\u003c/em\u003e, vol. 4, no. 4, pp. 299\u0026ndash;307, Dec. 2015, doi: 10.1556/2006.4.2015.037.\u003c/li\u003e\n\u003cli\u003eS. Maheshwari and S. Preksha, \u0026ldquo;Internet Addiction: A Growing Concern In India,\u0026rdquo; \u003cem\u003eIndian J. Psychiatr. Nurs.\u003c/em\u003e, vol. 15, no. 1, pp. 61\u0026ndash;68, Jan. 2018, doi: 10.4103/2231-1505.262510.\u003c/li\u003e\n\u003cli\u003eA. E. Kaprana \u003cem\u003eet al.\u003c/em\u003e, \u0026ldquo;Studying the effects of mobile phone use on the auditory system and the central nervous system: A review of the literature and future directions,\u0026rdquo; \u003cem\u003eEur. Arch. Oto-Rhino-Laryngology\u003c/em\u003e, vol. 265, no. 9, pp. 1011\u0026ndash;1019, 2008, doi: 10.1007/s00405-008-0703-z.\u003c/li\u003e\n\u003cli\u003eM. Kaur, D. S. K. Maheshwari, and A. Kumar, \u0026ldquo;Compulsive buying behavior and online shopping addiction among health science teachers,\u0026rdquo; \u003cem\u003eInt. J. Nurs. Care\u003c/em\u003e, vol. 7, p. 74, Jan. 2019, doi: 10.5958/2320-8651.2019.00014.0.\u003c/li\u003e\n\u003cli\u003eN. L. Bragazzi and G. Del Puente, \u0026ldquo;A proposal for including nomophobia in the new DSM-V.,\u0026rdquo; \u003cem\u003ePsychol. Res. Behav. Manag.\u003c/em\u003e, vol. 7, pp. 155\u0026ndash;160, 2014, doi: 10.2147/PRBM.S41386.\u003c/li\u003e\n\u003cli\u003eI. Asensio Chico, L. D\u0026iacute;az Maldonado, and L. Garrote Moreno, \u0026ldquo;[Nomophobia: Disorder of the 21st Century].,\u0026rdquo; \u003cem\u003eSemergen\u003c/em\u003e, vol. 44, no. 7. Spain, pp. e117\u0026ndash;e118, Oct. 2018, doi: 10.1016/j.semerg.2018.05.002.\u003c/li\u003e\n\u003cli\u003eAmerican Psychiatric Association, \u0026ldquo;DSM\u0026ndash;5 Manual,\u0026rdquo; \u003cem\u003eAm. Psychiatr. Assoc.\u003c/em\u003e, p. 9, 2013.\u003c/li\u003e\n\u003cli\u003eN. Sharma, P. Sharma, N. Sharma, and R. Wavare, \u0026ldquo;Rising concern of nomophobia amongst Indian medical students,\u0026rdquo; \u003cem\u003eInt. J. Res. Med. Sci.\u003c/em\u003e, vol. 3, p. 705, Jan. 2015, doi: 10.5455/2320-6012.ijrms20150333.\u003c/li\u003e\n\u003cli\u003eD. Gezgin, E. Sumuer, O. Arslan, and S. Yildirim, \u0026ldquo;Nomophobia Prevalence among Pre-service Teachers: A case of Trakya University,\u0026rdquo; \u003cem\u003eTrak. Univ. J. Educ. Fac.\u003c/em\u003e, vol. 7, Jan. 2017.\u003c/li\u003e\n\u003cli\u003eC. Yildirim and A.-P. Correia, \u0026ldquo;Exploring the dimensions of nomophobia: Development and validation of a self-reported questionnaire,\u0026rdquo; \u003cem\u003eComput. Human Behav.\u003c/em\u003e, vol. 49, pp. 130\u0026ndash;137, Aug. 2015, doi: 10.1016/j.chb.2015.02.059.\u003c/li\u003e\n\u003cli\u003eS. K. Muppalla, S. Vuppalapati, A. Reddy Pulliahgaru, and H. Sreenivasulu, \u0026ldquo;Effects of Excessive Screen Time on Child Development: An Updated Review and Strategies for Management.,\u0026rdquo; \u003cem\u003eCureus\u003c/em\u003e, vol. 15, no. 6, p. e40608, Jun. 2023, doi: 10.7759/cureus.40608.\u003c/li\u003e\n\u003cli\u003eJ. Gnanadhas, V. J, V. Menon, and J. Olickal, \u0026ldquo;Nomophobia: A Mixed-Methods Study on Prevalence, Associated Factors, and Perception among College Students in Puducherry, India,\u0026rdquo; \u003cem\u003eIndian J. Psychol. Med.\u003c/em\u003e, vol. 41, p. 541, 2019, doi: 10.4103/IJPSYM.IJPSYM_130_19.\u003c/li\u003e\n\u003cli\u003eM. Brand and M. N. Potenza, \u0026ldquo;Behavioral addictions in the ICD-11: An important debate that is anticipated to continue for some time.,\u0026rdquo; \u003cem\u003eJ. Behav. Addict.\u003c/em\u003e, vol. 12, no. 3, pp. 585\u0026ndash;589, Oct. 2023, doi: 10.1556/2006.2023.00042.\u003c/li\u003e\n\u003cli\u003eC. Fullwood, S. Quinn, L. K. Kaye, and C. Redding, \u0026ldquo;My virtual friend: A qualitative analysis of the attitudes and experiences of Smartphone users: Implications for Smartphone attachment,\u0026rdquo; \u003cem\u003eComput. Human Behav.\u003c/em\u003e, vol. 75, pp. 347\u0026ndash;355, 2017, doi: https://doi.org/10.1016/j.chb.2017.05.029.\u003c/li\u003e\n\u003cli\u003eP. Gupta \u003cem\u003eet al.\u003c/em\u003e, \u0026ldquo;Indian Academy of Pediatrics Guidelines on Screen Time and Digital Wellness in Infants, Children and Adolescents.,\u0026rdquo; \u003cem\u003eIndian Pediatr.\u003c/em\u003e, vol. 59, no. 3, pp. 235\u0026ndash;244, Mar. 2022.\u003c/li\u003e\n\u003cli\u003eN. Manjunatha, \u0026ldquo;Karnataka Mental Health (Manochaitanya) Programme: Indian Psychiatric Society \u0026ndash; Karnataka Chapter (IPS-KC) in \u0026lsquo;Public Private Partnership\u0026rsquo; (PPP) model,\u0026rdquo; \u003cem\u003eIndian Psychiatry Soc. Karnataka Chapter Newletter\u003c/em\u003e, vol. March 2016, p. 13, 2016.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 1: Baseline Demography\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"629\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCategories\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMean \u0026plusmn; Sd\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;20 Years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e278 (63.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e19.099 \u0026plusmn; 1.272 Years\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ge;20 Years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e158 (36.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMales\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e251(57.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eFemales\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e185(42.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eNumber Of Members In Family\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026le; 4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e287(65.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e4.667 \u0026plusmn; 2.730\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ge; 5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e149(34.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eSocio Economic Status *\u003c/p\u003e\n \u003cp\u003e(Modified BG Prasad scale 2023)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUpper\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e184(42.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUpper Middle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e169(38.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMiddle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e57(13.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLower Middle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e23(5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLower\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3(0.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eResidents of Hostel\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e150(34.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e286(65.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eOwn a phone of your own\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e419(96.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17(3.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eInternet activated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e401(92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e35(8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eLack of concentration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e216(49.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e220(50.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePhone checks per hour\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.549 \u0026plusmn; 5.210\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eCarrying phone charger to college\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e139(31.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e297(68.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eCheck phone more than 20 times a day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e283(64.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e153(35.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 2:\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNomophobia categories\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eN%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo NMP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2(0.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMild NMP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e83(19)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eModerate NMP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e267(61.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSevere NMP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e84(19.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 3: Associations with NMP\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eNMP Category\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eLack of concentration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eChi-Square Value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eP value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eYES (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNO (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eNo NMP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2(0.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e19.372*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eMild NMP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e36(8.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e47(10.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eModerate NMP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e121(27.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e146(33.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eSevere NMP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e59(13.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25(5.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e216(49.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e220(50.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePeople owning a phone of their own\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eNo NMP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMild NMP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eModerate NMP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSevere NMP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eChi-Square Value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eP Value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e1(0.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e77(18.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e261(62.29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e80(19.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e10.679**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e0.012\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e1(5.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6(35.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e6(35.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4(23.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*Fisher\u0026apos;s Exact \u0026nbsp; **Pearson\u0026rsquo;s Chi Square\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Nomophobia (NMP), Smartphone Usage, Mobile Phone Addictions, Prevalence, Behavioural Addictions, Mixed-methods study","lastPublishedDoi":"10.21203/rs.3.rs-6828290/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6828290/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction: \u003c/strong\u003eNomophobia, the fear of being without a mobile phone or unable to use it due to no signal or low battery, is increasingly common among college students due to growing smartphone reliance. This study evaluates the prevalence, associated factors, and perceptions of nomophobic behaviors and smartphone use among students in a professional education college in Anekal Taluk, Bangalore, using a mixed-methods approach.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eA cross-sectional study was conducted with 436 students using a validated questionnaire capturing socio-demographic details, smartphone usage, and the Nomophobia Questionnaire (NMP-Q). Focus group discussions (FGDs) with students and key informant interviews (KIIs) with professors and psychiatrists explored attitudes and experiences. Quantitative data were analyzed using SPSS V 21.0 with chi-square tests and logistic regression, while qualitative data underwent thematic inductive analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eParticipants had a mean age of 19.09 ± 1.27 years, with 57.6% male. Nomophobia prevalence was 19% mild, 61% moderate, and 19% severe. Significant associations linked nomophobic behaviors to phone ownership (p=0.012) and reduced concentration from overuse (p\u0026lt;0.000). Qualitative findings highlighted themes of health impacts, academic influence, recreational dynamics, and daily life integration.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDiscussion: \u003c/strong\u003eModerate nomophobia was highly prevalent, despite students’ awareness of excessive phone use risks. Associations with smartphone ownership and usage patterns underscore the need for health education and institutional policies to address adverse effects on students’ well-being.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eModerate nomophobia predominates among Bangalore college students. Interventions promoting awareness and encouraging social and physical activities are recommended to mitigate nomophobic behaviors.\u003c/p\u003e","manuscriptTitle":"Nomophobic behaviours among students in a selected college of higher education in Anekal Taluk, Bengaluru Urban District - A mixed-methods study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-23 02:40:24","doi":"10.21203/rs.3.rs-6828290/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-09-19T12:38:36+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-06T13:24:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"216403739887268274379577083226945238972","date":"2025-09-06T12:59:57+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-25T07:19:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"26992647436179245235585718292092136935","date":"2025-08-14T09:33:53+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-24T05:45:03+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"15696306088955109836859290867095240717","date":"2025-07-19T12:14:29+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-07-18T17:47:12+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-07-03T16:26:03+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-06-28T06:48:39+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Public Health","date":"2025-06-28T06:45:52+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d54af242-a0b6-4906-b9d5-d9e09a75e6be","owner":[],"postedDate":"July 23rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-11-24T16:10:36+00:00","versionOfRecord":{"articleIdentity":"rs-6828290","link":"https://doi.org/10.1186/s12982-025-01142-z","journal":{"identity":"discover-public-health","isVorOnly":false,"title":"Discover Public Health"},"publishedOn":"2025-11-23 15:59:16","publishedOnDateReadable":"November 23rd, 2025"},"versionCreatedAt":"2025-07-23 02:40:24","video":"","vorDoi":"10.1186/s12982-025-01142-z","vorDoiUrl":"https://doi.org/10.1186/s12982-025-01142-z","workflowStages":[]},"version":"v1","identity":"rs-6828290","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6828290","identity":"rs-6828290","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}