Yin J, Wang GD, Wu PX, Yang H, Liu ZS, Zhang YP. Associations of excessive smartphone duration and unlock frequency with non-suicidal self-injury in college students. World J Psychiatry 2026; 16(2): 112817 [DOI: 10.5498/wjp.v16.i2.112817]
Corresponding Author of This Article
Yan-Ping Zhang, PhD, Associate Chief Physician, Department of Laboratory, The Second Affiliated Hospital of Xi’an Jiaotong University, No. 157 West Wulu Road, Xincheng District, Xi’an 710004, Shaanxi Province, China. hongpijidan@mail.xjtu.edu.cn
Research Domain of This Article
Psychiatry
Article-Type of This Article
Observational Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Feb 19, 2026 (publication date) through Feb 2, 2026
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Journal Information of This Article
Publication Name
World Journal of Psychiatry
ISSN
2220-3206
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Yin J, Wang GD, Wu PX, Yang H, Liu ZS, Zhang YP. Associations of excessive smartphone duration and unlock frequency with non-suicidal self-injury in college students. World J Psychiatry 2026; 16(2): 112817 [DOI: 10.5498/wjp.v16.i2.112817]
Jian Yin, Ze-Shi Liu, Yan-Ping Zhang, Department of Laboratory, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, Shaanxi Province, China
Guang-Dong Wang, Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Pei-Xi Wu, Xi’an Mingde Institute of Technology, Xi’an 710124, Shaanxi Province, China
Hui Yang, Department of External Cooperation and Exchange, Shaanxi Provincial Health Commission, Xi’an 710003, Shaanxi Province, China
Co-first authors: Jian Yin and Guang-Dong Wang.
Author contributions: Yin J and Wang GD made equal contributions as co-first authors; Yin J, Wang GD, and Zhang YP contributed to the conception and design of the study, drafted the manuscript; Wu PX, Yang H, and Liu ZS contributed to the acquisition, analysis, or interpretation of data for the work; Zhang YP conducted critical revision of the manuscript before final approval for submission. All authors approved the final version to publish.
Institutional review board statement: This study is approved by the Second Affiliated Hospital of Xi’an Jiaotong University, No. 2022248.
Informed consent statement: All participants provided informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Dataset available from the corresponding author. Participants gave informed consent for data sharing was not obtained but the presented data are anonymized and risk of identification is low.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan-Ping Zhang, PhD, Associate Chief Physician, Department of Laboratory, The Second Affiliated Hospital of Xi’an Jiaotong University, No. 157 West Wulu Road, Xincheng District, Xi’an 710004, Shaanxi Province, China. hongpijidan@mail.xjtu.edu.cn
Received: August 20, 2025 Revised: September 30, 2025 Accepted: November 21, 2025 Published online: February 19, 2026 Processing time: 167 Days and 2.9 Hours
Abstract
BACKGROUND
The mental health impact of smartphone use remains incompletely understood. Although several prior studies have suggested a correlation between smartphone usage and non-suicidal self-injury (NSSI), reliance on self-reported data limits the accuracy of exposure assessment. Objective measurements are needed to elucidate this relationship better.
AIM
To examine the associations of objectively assessed smartphone duration and unlock frequency with NSSI.
METHODS
This cross-sectional study included 17851 college students from China. NSSI was assessed using the Ottawa Self-Injury Inventory, which includes ten NSSI behaviors. Smartphone duration and unlock frequency were objectively monitored through participant-submitted screenshots. Binary logistic and restricted cubic spline models were used for analyses.
RESULTS
Of 17851 participants, 460 (2.6%) exhibited NSSI in the past month. The mean (SD) weekly smartphone duration and unlock frequency were 49.1 (29.9) hours and 390.9 (278.2) times. After adjusting for sociodemographic characteristics, health-related behaviors, and negative life events, smartphone use was significantly and positively associated with NSSI. Compared to students with 0-21 hours/week of smartphone duration, those with ≥ 63 hours/week exhibited a significantly higher risk (odds ratio = 1.60; 95% confidence interval: 1.23-2.11). Similarly, compared to students with 0-50 times/week of smartphone unlock frequency, those with ≥ 400 times/week (odds ratio = 1.48; 95% confidence interval: 1.11-2.00) had significantly higher NSSI risk. Restricted cubic spline analyses confirmed a monotonic increase in NSSI risk with increasing smartphone duration (P value for non-linear = 0.971) and unlock frequency (P value for non-linear = 0.225).
CONCLUSION
Excessive smartphone duration and unlock frequency are associated with an elevated risk of NSSI among college students, underscoring the need to consider smartphone use behaviors in NSSI prevention.
Core Tip: The mental health impact of smartphone use remains incompletely understood. The present study assessed objective smartphone duration and unlock frequency by collecting participants’ smartphone use records screenshots, finding that excessive smartphone duration and unlock frequency were positively associated with non-suicidal self-injury among college students. Restricted cubic spline analyses found a monotonic increase in non-suicidal self-injury risk with increasing smartphone duration and unlock frequency, emphasizing the need to consider digital behavior patterns in developing prevention strategies.
