Have you ever heard of nomophobia? Digital dependency syndrome—the irrational and uncontrollable fear of being without a cell phone, electronic devices, or digital access in general—is known as nomophobia. This syndrome is described in the ICD, which is the International Classification of Diseases released online in 2018 by the World Health Organization (WHO). It is a highly reliable reference guide on mental disorders and serves as a solid foundation for identifying trends and statistics in mental health worldwide. It is now in its eleventh edition (ICD-11), which includes the abusive use of video games and other digital technologies as a disorder. The greater the dependence, the greater the phobia.

The WHO (World Health Organization) also defines addiction as a disease; that is, digital dependence and nomophobia are classified as pathologies. However, because they result from technological changes and advances, many people are not even familiar with the term “nomophobia.” These conditions have recently been included in studies and research, but with sufficient scientific evidence and results to stand alongside others, such as addictions to stimulants (cocaine), euphorogens (ecstasy), sedatives (anxiolytics), or hallucinogens (magic mushrooms). It is important to add that there is another nosological classification—or classification of disorders in the field of psychiatry—the French Classification of Mental Disorders in Children and Adolescents (CFTMEA, in French), which also identifies such harmful behaviors.

The Guide to Child and Adolescent Health in the Digital Age, published in 2016, is a useful resource for learning more, particularly regarding factors that interfere with and alter child and adolescent development in ways that are no longer healthy (5).

But what counts as excessive? Where is the limit?

I hope I don't disappoint you, dear reader, but in terms of scientific evidence, there is still no common ground among the studies, and they are not as conclusive as the correlations between duration of use and harm.

However, we know that video games—as well as internet use or excessive cell phone use—can lead to problems such as sleep disturbances, impulsivity, increased anxiety, depression, aggression, violence, and intolerance to frustration, among others.

Immediacy, the need to have everything “at the click of a button,” and a lack of patience are characteristics of these users that, on their own, do not foster their development—which inherently requires time, processes, and trade-offs. This obsession with the speed of things and information is contributing to a generation of children and young people who are focused on immediate gratification and have a lower tolerance for frustration. (FÓZ A. 2019)

We already know a great deal about how a child's brain matures and develops, so we can draw on our intuition, reliable information, and common sense.

Reflecting on what a child misses out on while staring at screens, and how disoriented they become when there’s no button to click—these are some points to consider. The growing number of obese children and the rise in childhood psychiatric problems are also obvious observations that are worth paying attention to.

Below is information that has already been widely reported: the guidelines from the American Academy of Pediatrics (AAP), which you can find on BBC News(1)*:

• For children under 18 months, avoid any screen time other than video calls;

• Parents of children between the ages of 18 and 24 months who wish to introduce digital media should choose high-quality programming and watch it together with their children to help them understand what they are seeing;

• For children ages 2 to 5, screen time should be limited to one hour per day and should consist of high-quality programming. Parents should watch with their children;

• For children ages 6 and older, set consistent limits, ensuring that screen time does not interfere with sleep and physical activity.

National and international research institutions are unanimous in stating that its use should always be supervised and that excessive and prolonged use should be avoided; this is also supported by statements from the Brazilian Society of Pediatrics (5).

• Children under 2 years of age: Do not use;
• Children ages 2 to 5: up to 1 hour per day;
• Children ages 6 to 10: up to 2 hours a day;
• Teens ages 11 to 18: up to 3 hours a day, and never stay up all night;
• All age groups: no screens during meals, and log off 1 to 2 hours before bedtime.

Every family has its own choices and dynamics, and we also need to keep in mind that the potential effects or harm caused by excessive exposure may not be immediately apparent, since children’s and adolescents’ brains are still developing and need to focus on certain priorities in order to reach their full potential.

And we must also accept that digital technology is here to stay—data from the Kiks Online ICT survey (2018), conducted by the Brazilian Internet Steering Committee (CGI.br), showed that 86% of Brazilian children and adolescents, ages 9 to 17, are online—so it is necessary to know how to handle and use it to the best of our ability. As Paracelsus, the renowned 16th-century physician, once said, “The difference between a remedy and a poison is the dose.”

I would therefore like to suggest a “balanced” approach—a reasonable way to help parents of young children recognize potential warning signs—based on the RCPCH (Royal College of Pediatrics and Child Health) (1) and other sources. I advise parents and guardians to ask themselves:

• Is screen time in your home monitored?

• Does screen time interfere with what the family wants to do?

• Has your child been sleeping well and getting enough sleep? And has their mood changed?

• Are you able to control what your child eats while they're using a screen?

• Does the child stop eating the foods they like in order to play or use electronic devices?

• Has your child been constantly replacing in-person relationships with online ones, avoiding the former?

• Do you stop doing other things you used to enjoy just to use your electronic device?

• Have you ever lied to cover up your use of electronics? Or do you try to hide the fact that you use them?

Believe it or not, these kinds of questions are more effective than setting an age limit or time limit for each age group!

Even for those who are reluctant to use digital devices and rely on information claiming that they are harmful to the eyes, this is not a scientific fact. So don’t use it to convince your children, because if they’ve learned to use digital devices more effectively, they’ll know that the American Academy of Ophthalmology states that staring directly at screens does not cause damage, though it can lead to eyestrain or dry eye syndrome, which can be treated with lubricating eye drops.

If you want to have any success with your children, seek to reach family agreements and set a good example; otherwise, you’ll cause more stress, and worse, the legitimacy of parental authority—which is so necessary and important—will be “erased” by your children. (Source: pediatrician Daniel Becker). This is an even higher price that everyone will pay in this case.

On the other hand, any child who may be spending too much time with digital devices and the digital world may have parents who go overboard.

Unfortunately, we have not yet found a study evaluating the effectiveness of any type of therapeutic intervention for adult gamers with serious video game addiction problems, nor for children. However, there is evidence supporting certain forms of intervention, such as supportive and counseling therapy, family therapy, and cognitive-behavioral therapy. Other techniques, such as neurofeedback and 3D glasses therapy, need further study. When choosing a therapist or therapy, listen to the professional, ask for examples and reliable recommendations, and pay attention to what your child says or expresses about the therapist. Ask questions, clarify any doubts, and trust your intuition and knowledge.

It should also be noted that addicts exhibit heightened forms of vulnerability as individuals and typically display low frustration tolerance, a strong avoidance of harm, above-normal anxiety, and low self-esteem.

We’ve mentioned the emotional and psychological aspects, but I can’t help but mention the cognitive aspects as well—such as attention, memory, and mental flexibility, among others—that are affected

Let’s prevent nomophobia from becoming an epidemic, but rather let it serve as a wake-up call and a way to raise awareness among adults for the sake of their children’s health and well-being.

 

 

 

 

Text based on the article “Nomophobia—Is My Child Addicted to Electronics?” posted on Neuroconecte’s neuroblog and on the A Escola Legal website, written by Adriana Fóz.
https://neuroconecte.com.br/nomofobia-dependencia-digital/
https://aescolalegal.com.br/nomofobia-filhos-viciados-em-eletronicos/

 

References:
 

1. ROBERTS, M. BBC News. Cell Phones and Tablets for Children: Spending Too Much Time on Electronics May Harm Development, January 2019.

Available at: https://www.bbc.com/portuguese/geral-47036386

 

2- "Psicologia Viva" Blog. What Is Nomophobia? Understanding Digital Dependency Syndrome, July 2018.

Available at: https://blog.psicologiaviva.com.br/dependencia-digital/

 

3- LIMA, R. C. Estilos da Clínica, 2019, Vol. 24, No. 1, pp. 173–177
DOI: 10.11606/issn.1981-1624.v24i1p173-177

 

4- ABREU, C. N. et al. Rev. Bras. Psiquiatr. 2008;30(2):156-67. Internet and video game addiction: a review.
https://doi.org/10.1590/S1516-44462008000200014

 

5- Brazilian Society of Pediatrics.The Guide to Child and Adolescent Health in the Digital Age, 2016 (revised in 2020). “
” available at: https://www.sbp.com.br/imprensa/detalhe/nid/sbp-atualiza-recomendacoes-sobre-saude-de-criancas-e-adolescentes-na-era-digital/

 

6- FÓZ, A. Frustration: How to Develop Your Emotional Skills to Face the Challenges of Your Personal and Professional Life. São Paulo: Benvirá, 2019.

 

*However, the Canadian Pediatric Society is even more explicit: no electronic devices should be used before the age of 2 (1).

 

 

 

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