The impact of smartphone addiction on depressive symptoms among medical students: a chain mediation model of self-acceptance and loneliness

Background: The primary importance of the mental health of medical students occurs in the context of the Healthy China 2030 Initiative since they will form the core workforce of the national medical and health system. Nevertheless, there is current data showing a surge in the prevalence of depressive symptoms in this group, with the overuse of smartphones cited as one of the key contributing factors. Objective: Although the strong relationship between smartphone addiction and depression has been established, there remain gaps in understanding the psychological processes that connect the two concepts. The sequential associations (i.e., cognitive and emotional processes) should be clarified, thus, it is imperative to at least identify the particular psychological pathway in the connection between smartphone addiction and depression in medical students. Methods: A cross-sectional survey was conducted on 823 medical students. To measure the levels of smartphone addiction, depressive symptoms, loneliness, and self-acceptance of participants, there was use of validated standardized questionnaires. The proposed Chain Mediation model was tested using SPSS 26.0. Results: < 0.001), but also shows an indirect association with them through three pathways. The chain mediation effect from "mobile addiction → self-acceptance → loneliness → depression" is significant (effect size = 0.18, 95% BootCI 0.09, 0.23), while the independent mediation effect of self-acceptance is not significant. Conclusion: Smartphone addiction mainly may contribute to depressive symptoms in medical students in a dynamic chain reaction, that is, first, it is related to lower self-acceptance, which in turn is associated with higher levels of loneliness, and ultimately, linked to more severe depressive symptoms. The issue of interventions on the mental health of medical students cannot thus be limited to restrictions on smartphone use. Rather, there is a recommendation to employ strategy-based techniques aimed at enhancing self-acceptance and counteracting loneliness to be a more effective approach to breaking the smartphone addiction-depression chain.