Association between problematic smartphone use and gaming and disruptive behavioral disorder symptoms among Korean adolescents: a nationwide representative study.

BACKGROUND

Problematic smart device use is a growing public health concern among adolescents and is often associated with disruptive behavioral disorders (DBDs). However, little is known about how these associations depend on parental and residential factors in nationally representative populations.

METHODS

Data were obtained from the 2022 Korean National Mental Health Survey of Children and Adolescents. The analysis was performed on the data of adolescents aged 12-17 years who completed the DBD questionnaire (n=3,084 for problematic smartphone use [PSU]; n=2,393 for problematic gaming [PG]). Multivariable logistic regression models were used to examine overall associations and associations in residency and parental characteristic subgroups.

RESULTS

Adolescents with PSU or PG showed significantly higher prevalence of all DBD subtypes (all p<0.01). Distinct subgroup patterns emerged: PSU was associated with conduct disorder (CD) only in urban areas (odds ratio [OR]=2.03, 95% confidence interval [CI]=1.30-3.16), whereas PG was more strongly associated with ADHD-inattentive symptoms in rural areas (rural: OR = 4.22, 95% CI = 2.15-8.30; urban: OR = 2.10, 95% CI = 1.49-2.96). The PSU-oppositional defiant disorder association was stronger among adolescents with highly educated mothers (OR = 3.64 vs. 1.93), while the PSU-CD link was evident only when fathers drank less frequently (OR = 2.15, 95% CI = 1.34-3.45).

CONCLUSIONS

PSU and PG show robust associations with all DBD subtypes, with distinct urban-rural and parental moderation patterns. If causal relationships are confirmed, targeted, family-based, and region-specific interventions may promote adolescent behavioral health at the national level.