Nomophobia and its association with academic performance and psychological distress using an explanatory sequential mixed methods cross sectional study

As smartphones have become an integral part of daily life, students often experience nomophobia (a fear of being without a mobile phone). This condition leads to stress, poor concentration, depression, and low academic performance among university students. Despite its relevance, this issue has yet to be explored in Pakistan among university students.

This study employed an explanatory sequential mixed-methods, cross-sectional design. A total of 733 full-time university students who owned smartphones were recruited at the University of Lahore. A self-administered questionnaire was used to collect data, which comprised five sections: demographic information & behavioral patterns, the NMPQ-20, DASS-21, academic performance, and an open-ended question for qualitative analysis. This phase was integrated to contextualize and triangulate findings.

The study revealed that nomophobia prevalence was 99.7% (731/733). Frequencies were: mild 6.3% (46/731), moderate 48.3% (354/731), and severe 45.2% (331/731). Psychological distress was prevalent: 30.2% (221/733) reported extremely severe depression, 59.6% (437/733) extremely severe anxiety, and 26.9% (197/733) severe stress. Nomophobia strongly correlated with depression, anxiety, and stress (p < .001). Higher nomophobia levels were significantly associated with lower CGPA, lower attendance, increased academic warnings, and reduced study hours (p < .001). Ordinal logistic regression identified female gender (OR = 1.56, p = .009), smartphone usage > 10 h/day (OR = 4.07, p = .004), > 1 academic warning (OR = 2.54, p = .001), and extremely severe stress (OR = 2.81, p = .009) as significant predictors. Triangulation revealed a dual emotional landscape: quantitative data confirmed compulsive dependency, while qualitative analysis indicated students perceive disconnection as both a source of anxiety and a welcome relief, suggesting nomophobia is a complex behavioral adaptation to societal pressures.

These findings suggest that higher levels of nomophobia are significantly associated with increased psychological distress and poorer academic performance among university students. Given its pervasive nature, nomophobia should be recognized as a public health priority in academic settings, warranting targeted interventions to mitigate its psychological and academic consequences while acknowledging that students rely on smartphones for safety and autonomy despite the compulsion to remain connected.