subfolder_0/A perspective of yoga on smartphone addiction A narrative review.txt

© 2022 Journal of Family Medicine and Primary Care | Published by Wolters Kluwer ‑ Medknow	
2284
Introduction
Technology is becoming ubiquitous. The evolution of 
smartphones has transformed usage dynamics regardless of 
age, gender, and economic status. The functions may vary from 
placing a phone call to checking email, online transactions, 
texting, surfing the web, playing online games, and listening to 
music.[1] This problematic overuse has led to addiction in the form 
of frequent checking of the smartphone.[2,3] Although addiction 
has been defined as “a pathological condition that one cannot 
tolerate without continuous administration of substances,” it 
is now applied to behavioral addictions, such as gaming and 
internet use.[4] A growing literature has confirmed that usage of 
smartphones is more evident among emerging adulthood, with 
an age range of 18–29 years.[5]
Although smartphone addiction is not recognized as a 
clinical disorder in the Diagnostic and Statistical Manual of 
Mental Disorders (DSM‑V) or International Classification of 
Diseases (ICD‑10), the estimated prevalence of smartphone 
addiction is in the range of  10% to 20%.[6] Studies have 
reported a prevalence of problematic smartphone use among 
children and adolescents as high as 10% in countries such as the 
United Kingdom,[7] 16.7% in Taiwan,[8]16.9% in Switzerland,[2] 
30.9% in Korea,[9] and 31% in India.[10] Further, a survey among 
the six Asian countries showed the highest prevalence of 
internet addiction through smartphone ownership is 62%.[11] 
Studies reported many aspects of problematic smartphone 
behavior are similar to other recognized behavioral addictions 
A perspective of yoga on smartphone addiction: 
A narrative review
Chaitanya K. Putchavayala1, Deepeshwar Singh2, Rajesh K. Sashidharan1
1Division of Yoga and Physical Science, 2Division of Yoga and Life Science, Swami Vivekananda Yoga 
AnusandhanaSamsthana (S‑VYASA), Bangalore, Karnataka, India
Abstract
Evolution in technology is drastically becoming automatic and making life easier. Among those technologies, smartphones are 
fast‑changing technology that is equipping humans to work from anywhere. Frequent usage and dependency on smartphones have 
increased, which in turn contributes to changes in psychosocial behavioral aspects. Addiction plays an important role in modifying 
the healthy habits of individuals. Problematic usage of smartphones affects both physical and psychosocial health and emerges as a 
cornerstone of psychosocial disorder. However, there is a dearth of data to understand the core concepts of smartphone addiction 
and there is a need to understand from the broader perspective. Yoga is considered one of the viable protocols to provide the way 
for digital detoxification from technology and smartphone addiction by promoting self‑regulation. Yoga brings back a healthy 
living style, which allows individuals to have enough physical activity through asanas, emotional stability, and awareness through 
meditation and breathing practices. We hypothesize that a holistic approach to yoga can regulate the symptoms associated with 
smartphone addiction by increasing the stability of the body and mind and promoting emotional detachment and self‑regulation, 
which play an important role in the de‑addiction process.
Keywords: Biopsychosocial model, digital‑detoxification, review, smartphone addiction, yoga
Review Article
Access this article online
Quick Response Code:
Website: 
www.jfmpc.com
DOI: 
10.4103/jfmpc.jfmpc_1765_21
Address for correspondence: Dr. Deepeshwar Singh,
Division of Yoga and Life Science, Swami Vivekananda Yoga 
Anusandhana Samsthana (S‑VYASA), Bangalore ‑ 560 105, 
Karnataka, India.
E‑mail: [email protected]
How to cite this article: Putchavayala CK, Singh D, Sashidharan RK. 
A  perspective of yoga on smartphone addiction: A  narrative review. 
J Family Med Prim Care 2022;11:2284-91.
This is an open access journal, and articles are distributed under the terms of the Creative 
Commons Attribution‑NonCommercial‑ShareAlike 4.0 License, which allows others to 
remix, tweak, and build upon the work non‑commercially, as long as appropriate credit is 
given and the new creations are licensed under the identical terms.
For reprints contact: [email protected]
Received: 03-09-2021	
	
Revised: 15-12-2021
Accepted: 16-12-2021	
	
Published: 30-06-2022
Putchavayala, et al.: A perspective of yoga on smartphone addiction: A narrative review
Journal of Family Medicine and Primary Care	
2285	
Volume 11  :  Issue 6  :  June 2022
such as gambling disorder and other traditional addictions 
(e.g., substance use, smoking, and alcohol). The pathological 
use of smartphones has created a new kind of maladaptive 
behavior and emerging as a cornerstone of  psychosocial 
disorders. Subsequently, researchers have shown greater interest 
in studying smartphone addiction.[2,12,13] The symptoms associated 
with problematic smartphone usage negatively influence 
physiological and psychosocial behavior[14] with low psychological 
well‑being,[15] depression, loneliness,[14] social anxiety,[16] and 
cognitive disorders.[17]
Given the current literature, researchers are actively exploring the 
significance of yoga and meditation as a viable tool for addressing 
psychological problems and addictive behaviors. Yoga is a 
communion of mind and body. Problematic smartphone usage is 
slowly and steadily gaining influence in manipulating psychosocial 
behavior. There is a dearth of data in this area to understand 
the core characteristics. Therefore, we hypothesize that there is 
a need to understand the problem in a much broader spectrum 
from the purview of yogic texts that can be recommended as 
primary care intervention.
Understanding Smartphone Addiction from a 
Biopsychosocial Perspective
The biopsychosocial model of  addiction posits that 
biological/genetic, psychological, and sociocultural factors 
contribute to substance use and all must be taken into 
consideration in prevention and treatment efforts.[18]
As explained in [Figure 1], smartphone addiction is a complex 
and heterogeneous problem,[6]and there is a need to understand 
it from a biopsychosocial perspective. Griffith has proposed 
the components model of addiction, which proposes that all 
addictions comprise a set of criteria that rewards physiological 
and psychosocial behaviors. He proposed six core components 
for understanding the biopsychosocial process of smartphone 
addiction. These are salience, mood modification, tolerance, 
withdrawal, conflict, and relapse.[19]
Salience
Predominant smartphone usage over other activities of 
life influences feelings (craving), cognitive distortions, and 
deterioration of  social behavior. A study on university 
students has shown high cognitive absorption levels among 
the smartphone‑addicted group.[20] Cognitive absorption is 
characterized by temporal dissociation, focused immersion, 
heightened enjoyment, control, and curiosity.[21] Further, an 
functional magnetic resonance imaging (fMRI) study reported 
that smartphone addiction inhibits cognitive control during 
emotional processing and influences social interaction.[22] 
Similarly, a neuroimaging study on adolescents with mobile phone 
addiction correlates higher impulsive scores with altered gray 
matter volume and white matter integrity.[23] Similarly, subjects 
with gaming addiction have shown enhanced craving and brain 
activity in the lateral and prefrontal cortex for gaming stimuli.[24]
Mood modification
The subjective experiences reported using smartphones as a 
coping strategy to avoid loneliness and dysphoric mood.[25] A 
study observed that students utilizing their mobile phones as a 
coping mechanism might get trivial appeasement for loneliness, 
boredom, and anxiety‑induced situations. However, long‑term 
utilization might negatively influence mental health.[26] A study 
reported that dysfunctional cognitive and emotional processes 
mediate anxiety, depression, and problematic smartphone 
usage.[27] Furthermore, smartphone addiction and childhood 
psychological maltreatment.[28] In a recent study with Indian 
university students, 43% agreed the mobile phone provides an 
escape from problems, and 70% agreed that the mobile phone 
helped them overcome bad moods such as feelings of inferiority, 
helplessness, guilt, anxiety, and depression.[29]
Tolerance
The prolonged time spent or frequent checking on smartphones 
to achieve the former mood modifying effects. Earlier studies 
claim that the frequent checking of smartphones is because of 
instant access to rewards. Further, social media has reportedly 
become the source of perceived social support.[30] Currently, 
people ascribe perceived social support by likes and shares on 
social networking sites (e.g., Facebook, Instagram, and Twitter) 
and communicating through icons.[31] A study has shown that 
Facebook connectedness is related to greater life satisfaction, 
lower anxiety, and depression levels, and enhanced social 
capital.[32] In contrast, extroverts and neurotics with a high 
Facebook usage negatively influence life satisfaction and social 
relationships.[33]
Withdrawal
Recent studies coined a new word Nomophobia (No mobile 
phone phobia), and FOMO, “fearing of  being without a 
mobile phone,” which is the condition of feeling anxiety when 
Figure 1: Bio psychosocial perspective of smartphone addiction
Putchavayala, et al.: A perspective of yoga on smartphone addiction: A narrative review
Journal of Family Medicine and Primary Care	
2286	
Volume 11  :  Issue 6  :  June 2022
missing their smartphones. This condition is widely visible in 
youngsters with low self‑esteem, anxiety, impulsiveness, and 
high extroversion/introversion levels.[34] Another study reported 
interpersonal sensitivity, obsession‑compulsion, and strong 
predictors for nomophobia.[35]
Conflict
Spending prolonged time on smartphones leads to intrapersonal 
and interpersonal conflicts, influencing their social relations with 
family and friends.[25] In addition, texting is a potential distractor 
among school and college students impacting classroom 
performance.[36] A study reported that the average time for 
distraction in class is less than 6 minutes.[37]Furthermore, there 
has been a decline in face‑to‑face interactions among teens and 
making them less talkative to adults.[38]
Relapse
There is not sufficient literature to support the relapse condition 
in smartphone addiction. This condition tends to check the 
smartphone to recur the previous hedonic experience after a 
long period of abstinence. Checking smartphones after waking 
up and before sleeping to get updated is associated with low 
self‑control.[39]
Understanding the Nature of Smartphone 
Addiction ThroughYoga
Addiction is defined as a behavior, over which an individual 
has impaired control with harmful consequences.[40] It can 
also be viewed as a result of  “mindless” states involving 
escapist attitudes, automatic thinking, emotional reactivity, 
social isolation, and low self‑regulation.[41] Research has 
pointed out that yoga helps control addictive symptoms by 
promoting self‑regulation.[42,43] According to the World Health 
Organization (WHO), psychological health is one of the key 
components in defining health. The core concepts of yoga 
emphasize the nature of the mind and its afflictions (Kleshas). 
Traditional texts such as Patanjali Yoga Sutras (PYS), Bhagavad 
Gita (BG), Hatha Yoga Pradipika (HYP), and Yoga Vasistha (YV) 
have highlighted the mind (Chitta) and the interplay of qualities 
of  a person (Gunas) on mental health, and the afflictions 
caused in the absence of  self‑control and self‑regulation. 
Sage Patanjali defines yoga as, when the perplexities of the 
thoughts are controlled by self‑regulation, the mind will reach 
its pristine (PSY1:2). The afflictions in the mind caused by 
these perplexing thoughts stem out from ignorance of the 
truth (Avidya), egoism or identity (Asmita), attachment (raga), 
aversion (Dwesha), and fear of losing (Abhinivesha) (PSY 2:3). 
Ayurveda says, “asatmyaindriyarthasannikarsha,” the unhealthy 
sensory perception causes disharmony in the body either as an 
increase or decrease of humor (doshas).
Sankhya’s philosophy postulates that qualities (Gunas) play a 
vital role in defining a person’s temperament (Swabhava). The 
Guans are classified into three types. Tamas is characterized by 
dullness, inactive, illusion, depression, laziness, impulsiveness, 
and excessive sleep. When Rajas is dominant, it symbolizes 
passion and desire, egoism, self‑centeredness, greed, restlessness, 
ambition, and a sense of  self‑gratification. Finally, Sattva 
is associated with stability, self‑control, clarity of thought, 
discipline, self‑regulation, one‑pointedness, meditative mind, 
and detachment.[44]
The constant use of smartphones has caused sensory overload 
invigorating the mind for repeated subjective experiences, 
and the propensity of these experiences is causing ill effects. 
According to BG, the pleasures from these sensual indulgences 
develop an attachment that ignites the desire to have more. 
When not fulfilled, it leads to anger. From anger comes the 
delusion, followed by loss of memory, and from that comes 
the destruction of  intellect, leading to the perished mind 
(BG 2:62‑63). Patanjali further explained how these obstacles 
manifest into afflictions (PSY 1:30 & 31).
The above picture [Figure 2] illustrates how these disturbances 
of the mind (Chittavikshepas) lead to mental agitation (Adhi) 
and further as a disease in the body (Vyadhi).
Researchers have found that personality with openness to 
experience, neuroticism, and extroversion correlates with 
the smartphone’s problematic  usage.[45,46] Afflictions of 
the mind explain the symptomatic nature of  smartphone 
addiction such as mental laziness  (Styana), idleness, and 
dullness; indecisiveness, doubtful  (Samsaya); carelessness, 
negligence, and procrastination (Pramada); laziness (Alasya); 
craving for enjoyment, sensuality  (Avirati); erroneous 
perception, false views (Brantidarsana); failing to attain desired 
results  (Alabdhabumikatva); instability  (Anavasthitatva). The 
ramifications of these are transmuted as a disease (Vyadhi) in the 
body as sorrow (Dukha), depression (Daurmanasya), shaking off 
the body (Aangamejayatva); unrhythmic breathing (Svasaprasvasa 
Vikshepa). According to yoga, disease (vyadhi) is of two types, 
disease born out of mind, stress born psychosomatic ailments, 
and neurotic problems (Adhija Vyadhi). The second category 
is external causes such as accidents, infections, injury, and 
non‑stress (AnadhijaVyadhi). According to the Yoga Vasistha, 
mind (Adhi) and disease (vyadhi) are the sources of suffering. 
Sometimes they follow each other, and at times they cause each 
other. At the outset, they both root from ignorance and lack of 
self‑control.[44]
Yoga for digital detoxification
Addiction is in opposition to the idea of autonomy.[47,48] Yoga 
helps develop the ability to connect with life, detox our mind, 
body, and emotions, and live a harmonious and meaningful 
life. Current literature has shown that yoga can be a viable tool 
to manage the afflictions of the body and mind by instigating 
self‑regulation with the combined practices of asana, pranayama, 
pratyahara, relaxation, and meditation.[41] These are better 
explained in detail as:
Putchavayala, et al.: A perspective of yoga on smartphone addiction: A narrative review
Journal of Family Medicine and Primary Care	
2287	
Volume 11  :  Issue 6  :  June 2022
Asanas
Asana is the Sanskrit word for physical posture that helps 
develop physical and mental stamina and strengthen willpower. 
In his yoga sutras (PSY), Patanjali expounds that the primary 
objective of asana is to develop steadiness with ease in the 
sitting posture and maintain an erect spine for the free flow of 
energy during meditation (PSY 2.46). The benefits of asana 
(Asana siddhi) can be reaped with dedication, uninterrupted 
practice, and a sense of reverence (PSY 1.14). Effects of asana 
are in the order of somatopsychic, which includes the release 
of endorphins that induce a sense of relaxation, ease, and 
well‑being in the practitioner.[49] A study reported that after 1 h 
of a yoga asana session, there had been an increase of 27% in 
GABA (gamma‑aminobutyric acid) levels.[50,51] Further, induced 
stress levels were rescinded with Shavasana compared to supine 
postures and resting in a chair.[52] Another study reported that 
techniques using a combination of stimulation followed by 
relaxation had reduced oxygen consumption, energy expenditure, 
and physiological arousal compared to other relaxation 
techniques.[53]
Pranayama
Pranayama is the process of  controlling the life force. 
”Pran”’ means breath, life force; ”Ayama” is lengthening or 
extension through control. Patanjali expounds pranayama 
is much more than inhalation and exhalation of  breath. It 
is the process of  slow and extended inhalation  (puraka) 
followed by (kumbhaka) retention of  breath and (rechaka) 
the slow exhalation PYS (2:49). Regular practice improves the 
functioning of  vital systems of  the body. Mind is a complex 
structure and highly volatile. Controlling it is a daunting task. 
The breathing process is connected with the brain and the 
central nervous system, which is the gateway for emotional 
responses. Pranayama controls the erratic impulses in the 
brain by regulating the rhythms of  breath. Recent evidence 
suggests that rapid breathing  (Bhastrika) pranayama has 
significantly reduced anxiety and stress levels and affects the 
brain’s areas involved in processing emotions, attention, and 
awareness.[54] It has also shown a reduction in craving with 
smoking addiction,[55] anxiety, and depression.[56] Further, 
bhramari pranayama enhanced response inhibition and 
cognitive abilities.[57]
Pratyahara
Pratyahara is the fifth limb of Astanga yoga. Pratyahara has a 
pivotal role in the process of de‑addiction. Pratyahara refers 
to the conscious withdrawal of the mind from the sensual 
gratifications (PSY 2:54). Controlling the mind that is conditioned 
to seek sensual gratifications is challenging. The highest form 
of pratyahara is not about suppressing the senses; however, 
sublimating them inward to get into the depths of the mind 
(PSY 2.55). The other way of doing it is focusing on the space 
between the two eyebrows with a steady breath; one can gain 
control over the senses (BG 5.27‑28). Addiction is primarily 
because of craving and lack of self‑control.[58] Sensory indulgence 
is the main form of entertainment prevailing with smartphone 
addiction. Indriya (senses) Pratyahara helps understand the nature 
of craving and restrain the senses from external gratification by 
abstaining from these devices to rejuvenate the mind through 
awareness and self‑control.
Meditation
The outset of meditation transpires through Abhyasa (practice) 
and Vairagya  (detachment)  (PSY 1. 13&16). The practice 
of pratyahara promotes detachment towards the objects of 
sensuality. Meditation is referred to as dhyana in yoga. The 
mind with an uninterrupted flow of consciousness is called 
dhyana (PSY 3.2). Over time, various techniques of mediation 
have been evolved from different schools of thought. West 
has shown greater interest in mindfulness and transcendental 
meditation. They are extensively studied for their therapeutical 
benefits in physiological and psychosocial disorders. Studies 
have reported mindfulness meditation increases somatosensory 
processing,[59] sleep,[60] quality of life,[61] and reduced emotional 
reactivity.[62] Further, it effectively controls stress,[63] anxiety,[64] 
and depression levels.[65] Studies on addiction have reported 
meditation increases prefrontal activation, which might help in 
the de‑automatization of addictive responses[66] and improved 
cognitive functions,[67] response inhibition,[68]self‑control,[69] 
psychological well‑being,[70] and abstinence from craving.[71,72]
Figure 2: Illustration of mental agitation by Maharshi Patanjali
Putchavayala, et al.: A perspective of yoga on smartphone addiction: A narrative review
Journal of Family Medicine and Primary Care	
2288	
Volume 11  :  Issue 6  :  June 2022
Discussion
Addiction is defined by the American Society of Addiction 
Medicine (ASAM) as a primary, chronic disease of the brain’s 
reward, motivation, memory, and related circuitry. Dysfunction 
in these circuits results in distinct biological, psychological, 
social, and spiritual manifestations.[73] According to one study, 
internet addiction causes an increase in dopamine in the brain, 
just like any other substance addiction.[74] Excessive use of 
the internet through smartphones is a relatively new type of 
addiction. The condition is not officially recognized by the 
American Psychiatric Association. Nonetheless, many medical 
professionals and researchers around the world recognize it as a 
behavioral addiction. According to several studies, excessive use 
of smartphones, such as gambling, can change and negatively 
impact an individual over time. Further, issues arising from 
excessive smartphone use are a growing social issue that is being 
debated globally. Many studies have found that the prevalence 
is high among young adults. Mental illness during the critical 
period of emerging adulthood can result in lifelong disability by 
impairing an individual’s ability to develop socially, occupationally, 
and educationally.[75] Currently, individuals visiting the clinics 
of primary care and psychologists with complaints of anxiety, 
loneliness, depression, and sleep related problems.[76] Reports 
suggest that incidence of musculoskeletal pain, pain in the lower 
back, neck and shoulders are also on the rise.[77]
Further, research has shown that family environment is one of the 
strong predictors of adolescent internet addiction. Furthermore, 
studies reported there is a relationship between communication, 
attitude, and cohesiveness in the family and adolescent internet 
addiction.[78] This highlights the care that should be taken by 
family members and primary care physicians to prevent the 
spread of this maladaptive behavior. Recent evidence shows that 
the Cognitive Behavioral Model, exercise therapy, and art therapy 
are effective in reducing anxiety, depression, impulsiveness, and 
with drawl symptoms for smartphone and internet addiction.[79,80] 
However, there is a dearth of data and further investigations are 
required to address this problem in a holistic way.
In contrast, yoga is proven to be a viable tool to address 
physiological, psychosocial, and addictive behaviors by promoting 
self‑regulation and self‑control. Yoga is a holistic process of 
bringing body, mind, and spirit into communion. It has a lineage 
of more than 5000 years. It has shown a positive effect on 
perceived stress and quality of life with regular practice among 
young adults by cultivating subjective well‑being.[81] Empirical 
evidence report that regular practice of yoga in a school has 
a positive influence on dysphoric moods, emotion regulation, 
and self‑esteem.[82] A review postulated that regular practice of 
yoga and meditation has enhanced attention and their functional 
anatomical relationships along with an increase in the gray matter 
volume enabling individuals to control movement, memory, and 
emotions.[83] Including yoga as an adjunct treatment modality by 
the primary care centers and doctors would help in upholding 
the biopsychosocial dimensions of health in society.
Conclusion
According to recent evidence, researchers are paying more 
attention to studies on behavioral addictions. Because of its 
problematic and maladaptive behavior, studies on smartphone 
addiction have recently increased. Despite this, some studies 
claim that the prevalence is only 10% to 20%. Because of its 
market penetration and presence in modern life, there is a need 
for a broader understanding of the problems associated with it 
from a biopsychosocial perspective.
Yoga, in contrast, appears to be a promising treatment for 
addiction and other psychiatric disorders. Its ability to connect 
with life aids in the detoxification of our minds and bodies, 
as well as the regulation of emotions, thereby improving our 
well‑being. This is an important aspect of addressing addiction’s 
craving, compulsive behavior, tolerance, and relapse conditions. 
As a result, incorporating yoga and meditation into daily life will 
aid in the regulation of the symptoms of maladaptive behavior 
associated with smartphone addiction.
Key message
The excessive use of smartphones is negatively influencing 
people's behavior. Looking at the problem from a bio-psychosocial 
standpoint would help us understand its complexities. Yoga is 
a mind-body medicine, allows us to understand the nature of 
behaviour in a holistic way, as well as a possible solution to 
this maladaptive behavior, by promoting self-regulation and by 
cultivating subjective well-being.
Highlight
•	
Understanding smartphone addiction from the viewpoint of 
modern psychology and yoga
•	
Giving the perspective of yoga as a viable solution to control 
the symptoms of smartphone addiction.
•	
Including yoga as an adjunct treatment modality would be 
beneficial for the family and primary care doctors.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
1.	
Samaha  M, Hawi  NS. Relationships among smartphone 
addiction, stress, academic performance, and satisfaction 
with life.Comput HumBehav 2016;57:321‑25.
2.	
Haug S, Castro RP, Kwon M, Filler A, Kowatsch T, Schaub MP. 
Smartphone use and smartphone addiction among young 
people in Switzerland. J Behav Addict 2015;4:299‑307.
3.	
Oulasvirta  A, Rattenbury  T, Ma  L, Raita  E. Habits make 
smartphone use more pervasive. Pers Ubiquitous Comput 
2012;16:105‑14.
4.	
Kwon M, Lee JY, Won WY, Park JW, Min JA, Hahn C, et al. 
Putchavayala, et al.: A perspective of yoga on smartphone addiction: A narrative review
Journal of Family Medicine and Primary Care	
2289	
Volume 11  :  Issue 6  :  June 2022
Development and validation of a smartphone addiction 
scale (SAS).PLoS One 2013;8:e56936. doi: 10.1371/journal.
pone.0056936.
5.	
Arnett JJ. Presidential address: The emergence of emerging 
adulthood.EmergAdulthood 2014;2:155‑62.
6.	
Billieux  J, Maurage  P, Lopez‑Fernandez  O, Kuss  DJ, 
Griffiths  MD. Can disordered mobile phone use be 
considered a behavioral addiction? An update on current 
evidence and a comprehensive model for future research.
Curr Addict Rep2015;2:156‑62.
7.	
Lopez‑Fernandez O, Honrubia‑Serrano L, Freixa‑Blanxart M, 
Gibson  W. Prevalence of problematic mobile phone 
use in British adolescents. CyberpsycholBehavSocNetw 
2014;17:91‑8.
8.	
Yen CF, Tang TC, Yen JY, Lin HC, Huang CF, Liu SC, et al. 
Symptoms of problematic cellular phone use, functional 
impairment and its association with depression among 
adolescents in Southern Taiwan. J Adolesc 2009;32:863‑73.
9.	
Cha  SS, Seo  BK. Smartphone use and smartphone 
addiction in middle school students in Korea: 
Prevalence, social networking service, and game use. 
Health Psychol Open 2018;5:2055102918755046. doi: 
10.1177/2055102918755046.
10.	 Schacht JP, Anton RF, Myrick H. Functional neuroimaging 
studies of alcohol cue reactivity: A quantitative meta‑analysis 
and systematic review. Addict Biol 2013;18:121‑33.
11.	 Mak  KK, Lai  CM, Watanabe  H, Kim  DI, Bahar  N, 
Ramos  M, et  al. Epidemiology of internet behaviors and 
addiction among adolescents in six Asian countries. 
CyberpsycholBehavSocNetw 2014;17:720‑8.
12.	 Aljomaa  SS, Mohammad  MF, Albursan  IS, Bakhiet  SF, 
Abduljabbar  AS, et  al. Smartphone addiction among 
university students in the light of some variables. Comput 
Human Behav 2016;61:155‑64.
13.	 Bian M, Leung L. Linking loneliness, shyness, smartphone 
addiction symptoms, and patterns of smartphone use to 
social capital. SocSciComput Rev 2015;33:61‑79.
14.	 Kee IK, Byun JS, Jung JK, Choi JK. The presence of altered 
craniocervical posture and mobility in smartphone‑addicted 
teenagers with temporomandibular disorders. J PhysTherSci 
2016;2:339‑46.
15.	 Lai CM, Mak KK, Watanabe H, Jeong J, Kim D, Bahar N, et al. 
The mediating role of Internet addiction in depression, 
social anxiety, and psychosocial well‑being among 
adolescents in six Asian countries: A structural equation 
modelling approach. Public Health 2015;129:1224‑36.
16.	 Lee  B, Kim  S, Kim  Y, Bae  JY, Woo  SK, Woo  HN, et  al. 
The relationship between smartphone usage time and 
physical and mental health of university students. JKorean 
SocSchHealth 2013;26:45‑53.
17.	 Deshpande  A. Mobile addiction and associated factors 
amongst youth. J Ment Health 2015;2:244.
18.	 Skewes  CM, Vivian  MG. The BiopsychosocialModel of 
Addiction, Peter M. Miller, Principles of Addiction. 
Calofornia, USA; 2013. Pp. 61-70
19.	 Griffiths M. A “components” model of addiction within a 
biopsychosocial framework. J Subst Use2005;10:191.
20.	 Barnes  SJ, Pressey  AD, Scornavacca  E. Mobile ubiquity: 
Understanding the relationship between cognitive 
absorption, smartphone addiction and social network 
services. Comput Human Behav 2019;90:246‑58.
21.	 Agarwal  R, Karahanna  E. Time flies when you’re having 
fun: Cognitive absorption and beliefs about information 
technology usage. ManagInfSyst Q 2000;24:665‑94.
22.	 Chun JW, Choi J, Kim JY, Cho H, Ahn KJ, Nam JH, et al. 
Altered brain activity and the effect of personality traits in 
excessive smartphone use during facial emotion processing. 
Sci Rep 2017;7:12156. doi: 10.1038/s41598‑017‑08824‑y.
23.	 Wang Y, Zou Z, Song H, Xu X, Wang H, d’OleireUquillas F, 
Huang  X. Altered gray matter volume and white matter 
integrity in college students with mobile phone dependence. 
Front Psychol 2016;7:597.doi: 10.3389/fpsyg. 2016.00597.
24.	 Kim M, Lee TH, Choi JS, Kwak YB, Hwang WJ, Kim T, et al. 
Dysfunctional attentional bias and inhibitory control during 
anti‑saccade task in patients with internet gaming disorder: 
An eye tracking study.ProgNeuropsychopharmacolBiol 
P s y c h i a t r y  2 0 1 9 ; 9 5 : 1 0 9 7 1 7 . d o i :  1 0 . 1 0 1 6 / j .
pnpbp.2019.109717.
25.	 Jameel  S, Shahnawaz  MG, Griffiths  MD. Smartphone 
addiction in students: A  qualitative examination of 
the components model of addiction using face‑to‑face 
interviews. J Behav Addict 2019;8:780‑93.
26.	 Panova T, Lleras A. Avoidance or boredom: Negative mental 
health outcomes associated with use of information and 
communication technologies depend on users’ motivations. 
Comput Human Behav 2016;58:249‑58.
27.	 Elhai JD, Yang H, Montag C. Cognitive‑ and emotion‑related 
dysfunctional coping processes: Transdiagnosticmechanisms 
explaining depression and anxiety’s relations with 
problematic smartphone use. CurrAddictRep 2019;6:410‑17.
28.	 Liu F, Zhang Z, Chen L. Mediating effect of neuroticism and 
negative coping style in relation to childhood psychological 
maltreatment and smartphone addiction among college 
students in China. Child Abuse Negl 2020;106:104531.doi: 
10.1016/j.chiabu. 2020.104531.
29.	 Nehra R, Kate N, Grover S, Khehra N, Basu D. Does the excessive 
use of mobile phones in young adults reflect an emerging 
behavioral addiction? J Postgrad Med2012;46:177‑82.
30.	 Wohn DY, Carr CT, Hayes RA. How affective is a “like”? The 
effect of paralinguistic digital affordances on perceived 
social support.CyberpsycholBehavSocNetw 2016;19:562‑6.
31.	 Hayes RA, Carr CT, Wohn DY. One click, many meanings: 
Interpreting paralinguistic digital affordances in social 
media. J Broadcast Electron Media 2016;60:171‑87.
32.	 Valenzuela  S, Park  N, Kee  KF. Is there social capital 
in a social network site?: Facebook use and college 
students’ life satisfaction, trust, and participation. 
J Comput‑MediatComm 2009;14:875‑901.
33.	 Chan TH. Facebook and its effects on users’ empathic social 
skills and life satisfaction: A double‑edged sword effect. 
CyberpsycholBehavSocNetw 2014;17:276‑80.
34.	 Bhattacharya  S, Bashar  MA, Srivastava  A, Singh  A. 
Nomophobia: No mobile phone phobia. J Family Med Prim 
Care 2019;8:1297‑1300.
35.	 Gonçalves S, Dias P, Correia A‑P. Nomophobia and lifestyle: 
Smartphone use and its relationship to psychopathologies. 
Comput Human Behav 2020;2:100025.doi: 10.1016/j.chbr. 
2020.100025.
36.	 Lister‑Landman  KM, Domoff  SE, Dubow  EF. The role of 
compulsive texting in adolescents’ academic functioning.
Psychol Pop Media Cult 2017;6:311‑25.
37.	 Rosen  LD, Mark Carrier  L, Cheever  NA. Facebook and 
texting made me do it: Media‑induced task‑switching while 
studying. ComputHumanBehav 2013;29:948‑58.
Putchavayala, et al.: A perspective of yoga on smartphone addiction: A narrative review
Journal of Family Medicine and Primary Care	
2290	
Volume 11  :  Issue 6  :  June 2022
38.	 Chan NN, Walker C, Gleaves A. An exploration of students’ 
lived experiences of using smartphones in diverse learning 
contexts using a hermeneutic phenomenological approach. 
ComputEduc 2015;82:96‑106.
39.	 Khang  H, Kim  JK, Kim  Y. Self‑traits and motivations as 
antecedents of digital media flow and addiction: The 
Internet, mobile phones, and video games. Comput Human 
Behav 2013;29:2416‑24.
40.	 West R. Theories of addiction. Addiction 2001;1:3‑13.
41.	 Khanna  S, Greeson  JM. A  narrative review of yoga and 
mindfulness as complementary therapies for addiction.
Complement Ther Med 2013;3:244‑52.
42.	 Richter S, Tietjens M, Ziereis S, Querfurth S, Jansen P. Yoga 
training in junior primary school‑aged children has an 
impact on physical self‑perceptions and problem‑related 
behavior. Front Psychol 2016;7:203.doi: 10.3389/fpsyg. 
2016.00203.
43.	 Butzer B, LoRusso A, Shin SH, Khalsa SB. Evaluation of yoga 
for preventing adolescent substance use risk factors in a 
middle school setting: A  preliminary group‑randomized 
controlled trial. J Youth Adolesc 2017;46:603‑32.
44.	 Saraswati SS. Four Capters on Freedom. New Delhi: Yoga 
Publications Trust, Ganga Darshan, Munger, Bihar, India; 
2016.
45.	 Marengo D, Sindermann C, Häckel D, Settanni M, Elhai JD, 
Montag C. The association between the Big Five personality 
traits and smartphone use disorder: A  meta‑analysis. 
J Behav Addict 2020;9:534‑50.
46.	 Takao  M. Problematic mobile phone use and big‑five 
personality domains. Indian J Community Med 
2014;39:111‑3.
47.	 Harwood  J, Dooley  JJ, Scott  AJ, Joiner  R. Constantly 
connected‑The effects of smart‑devices on mental health.
Comput Human Behav 2014;34:267‑72.
48.	 Sohn SY, Rees P, Wildridge B, Kalk NJ, Carter B. Prevalence 
of problematic smartphone usage and associated mental 
health outcomes amongst children and young people: 
A  systematic review, meta‑analysis and GRADE of the 
evidence. BMC Psychiatry 2019;19:356.doi: 10.1186/
s12888‑019‑2350‑x.
49.	 Balayogi  A. Somato‑psychic aspects of asana (Yogic 
postures). AnnYoga PhysTher 2018;3:1.
50.	 Streeter CC, Jensen JE, Perlmutter RM, Cabral HJ, Tian H, 
Terhune  DB, Ciraulo  DA, Renshaw  PF. Yoga Asana 
sessions increase brain GABA levels: A pilot study. JAltern 
Complement Med 2007;13:419‑26.
51.	 S Streeter  CC, Whitfield  TH, Owen  L, Rein  T, Karri  SK, 
Yakhkind A, et al. Effects of yoga versus walking on mood, 
anxiety, and brain GABA levels: A randomized controlled 
MRS study. J Altern Complement Med 2010;16:1145‑52.
52.	 Bera TK, Gore MM, Oak JP. Recovery from stress in two 
different postures and in Shavasana‑a yogic relaxation 
posture. Indian J PhysiolPharmacol 1998;42:473‑8.
53.	 Subramanya  P, Telles  S. Effect of two yoga‑based 
relaxation techniques on memory scores and state anxiety. 
Biopsychosoc Med 2009;3:8.doi: 10.1186/1751‑0759‑3‑8.
54.	 Novaes  MM, Palhano‑Fontes  F, Onias  H, Andrade  KC, 
Lobão‑Soares  B, Arruda‑Sanchez  T, et  al. Effects of 
yoga respiratory practice  (Bhastrika pranayama) on 
anxiety, affect, and brain functional connectivity and 
activity: A  randomized controlled trial. Front Psychiatry 
2020;11:467.doi: 10.3389/fpsyt.2020.00467.
55.	 Lotfalian  S, Spears  CA, Juliano  LM. The effects of 
mindfulness‑based yogic breathing on craving, affect, and 
smoking behavior.Psychol Addict Behav 2020;34:351‑59.
56.	 Brown  RP, Gerbarg  PL. SudarshanKriya yogic breathing 
in the treatment of stress, anxiety, and depression: 
Part I‑neurophysiologic model. J Altern Complement Med 
2005;1:189‑201.
57.	 Rajesh SK, Ilavarasu JV, Srinivasan TM, Nagendra HR. Stress 
and its expression according to contemporary science and 
ancient Indian wisdom: Perseverative cognition and the 
Pañcakośas. Mens Sana Monogr 2014;1:139‑52.
58.	 Lyvers M. “Loss of control” in alcoholism and drug addiction: 
A neuroscientific interpretation. ExpClinPsychopharmacol 
2000;8:225‑49.
59.	 Kerr  CE, Sacchet  MD, Lazar  SW, Moore  CI, Jones  SR. 
Mindfulness starts with the body: Somatosensory attention 
and top‑down modulation of cortical alpha rhythms in 
mindfulness meditation. Front Hum Neurosci 2013;7:12.
doi: 10.3389/fnhum. 2013.00012.
60.	 Ong  JC, Manber  R, Segal  Z, Xia  Y, Shapiro  S, Wyatt  JK. 
A randomized controlled trial of mindfulness meditation 
for chronic insomnia. Sleep 2014;37:1553‑63.
61.	 Bueno VF, Kozasa EH, da Silva MA, Alves TM, Louzã MR, 
Pompéia S. Mindfulness meditation improves mood, 
quality of life, and attention in adults with attention deficit 
hyperactivity disorder. Biomed Res Int 2015;2015:962857.
doi: 10.1155/2015/962857.
62.	 Froeliger  BE, Garland  EL, Modlin  LA, McClernon  FJ. 
Neurocognitive correlates of the effects of yoga meditation 
practice on emotion and cognition: A  pilot study. Front 
IntegrNeurosci 2012;6:48.doi: 10.3389/fnint. 2012.00048.
63.	 Goyal M, Singh S, Sibinga EM, Gould NF, Rowland‑Seymour A, 
Sharma R, et al. Meditation programs for psychological stress 
and well‑being: A  systematic review and meta‑analysis. 
JAMA Intern Med 2014;174:357‑68.
64.	 Ando M, Morita T, Akechi T, Ito S, Tanaka M, Ifuku Y, et al. 
The efficacy of mindfulness‑based meditation therapy on 
anxiety, depression, and spirituality in Japanese patients 
with cancer. J Palliat Med 2009;12:1091‑4.
65.	 Jain  FA, Walsh  RN, Eisendrath  SJ, Christensen  S, 
Rael Cahn B. Critical analysis of the efficacy of meditation 
therapies for acute and subacute phase treatment of 
depressive disorders: A systematic review. Psychosomatics 
2015;56:140‑52.
66.	 Garland EL, Howard MO. Mindfulness‑based treatment of 
addiction: Current state of the field and envisioning the 
next wave of research. Addict SciClinPract 2018;13:14.
67.	 Newberg  AB, Wintering  N, Khalsa  DS, Roggenkamp  H, 
Waldman  MR. Meditation effects on cognitive function 
and cerebral blood flow in subjects with memory loss: 
A preliminary study. J Alzheimers Dis 2010;20:517‑26.
68.	 Alfonso  JP, Caracuel  A, Delgado‑Pastor  LC, 
Verdejo‑García A. Combined goal management training and 
mindfulness meditation improve executive functions and 
decision‑making performance in abstinent polysubstance 
abusers. Drug Alcohol Depend 2011;117:78‑81.
69.	 Tang YY, Ma Y, Wang J, Fan Y, Feng S, Lu Q, et al. Short‑term 
meditation training improves attention and self‑regulation. 
ProcNatlAcadSci U S A 2007;104:17152‑6.
70.	 Auty  KM, Cope  A, Liebling  A. A  systematic review and 
meta‑analysis of yoga and mindfulness meditation in 
prison.Int J Offender Ther Comp Criminol 2017;61:689‑710.
Putchavayala, et al.: A perspective of yoga on smartphone addiction: A narrative review
Journal of Family Medicine and Primary Care	
2291	
Volume 11  :  Issue 6  :  June 2022
71.	 Garland  EL, Froeliger  B, Howard  MO. Effects 
of mindfulness‑oriented recovery enhancement on 
reward responsiveness and opioid cue‑reactivity. 
Psychopharmacology (Berl) 2014;231:3229‑38.
72.	 Witkiewitz K, Bowen S. Depression, craving, and substance 
use following a randomized trial of mindfulness‑based 
relapse prevention. J Consult ClinPsychol 2010;78:362‑74.
73.	 Smith  DE. The process addictions and the new ASAM 
definition of addiction. J Psychoactive Drugs 2012;44:1‑4.
doi: 10.1080/02791072.2012.662105.
74.	 David NG. The Addictive Properties of Internet Usage, 
editors. Young KS, Abreu, Cristiano Nabuco de, Internet 
Addiction, John Wiley & Sons, Inc., Hoboken, New Jersey: 
2011;3-17.
75.	 Wood D, Crapnell T, Lau L, Bennett A, Lotstein D, Ferris M, 
et  al. Emerging adulthood as a critical stage in the life 
course. 2017 Nov 21. In: Halfon N, Forrest CB, Lerner RM, 
Faustman  EM, editors. Handbook of Life Course Health 
Development. Switzerland 2018;123-143.
76.	 Alkhateeb A, Alboali R, Alharbi W, Saleh O. Smartphone 
addiction and its complications related to health and 
daily activities among university students in Saudi Arabia: 
A multicenter study. J Fam Med Prim Care 2020;9:3220‑4.
77.	 Behera  P, Majumdar  A, Revadi  G, Santoshi  J, Nagar  V, 
Mishra N. Neck pain among undergraduate medical students 
in a premier institute of central India: A  cross‑sectional 
study of prevalence and associated factors. J Fam Med Prim 
Care 2020;9:3574‑81.
78.	 Nam Y‑O. A  study on the psychosocial variables of the 
youth’s addiction to internet and cyber sex and their 
problematic behavior. Korean J Soc Welf 2002;50:173‑207.
79.	 Ju Kim  D. A  systematic review on the intervention 
program of smartphone addiction. J Korea Acad Coop Soc 
2020;21:276‑88.
80.	 Kim H. Exercise rehabilitation for smartphone addiction. 
J Exerc Rehabil 2013;9:500‑5.
81.	 Gard T, Brach N, Hölzel BK, Noggle JJ, Conboy LA, Lazar SW, 
et al. Effects of a yoga‑based intervention for young adults 
on quality of life and perceived stress: The potential 
mediating roles of mindfulness and self‑compassion. J Posit 
Psychol 2012;7:165‑75.
82.	 Janjhua Y, Chaudhary R, Sharma N, Kumar K. A study on 
effect of yoga on emotional regulation, self‑esteem, and 
feelings of adolescents. J Fam Med Prim Care 2020;9:3381‑6.
83.	 Van Aalst  J, Ceccarini  J, Demyttenaere  K, Sunaert  S, 
Van Laere  K. What has neuroimaging taught us on the 
neurobiology of yoga? A review. Front Integr Neurosci 
2020;14:34.doi: 10.3389/fnint. 2020.00034.