Which Symptoms of Nomophobia, Social Networking Site Addiction, and Fear of Missing Out (FoMO) Directly Affect Mental Health? A Symptom Network and Flow Analysis Study

Abstract

Nomophobia, social networking site (SNS) addiction, and fear of missing out (FoMO) are increasingly recognized as interrelated digital-age phenomena that pose risks to young people's mental health. However, limited research has examined how specific symptoms across these domains interact and contribute to anxiety and depression. This study aims to make a novel contribution by applying network and flow analysis to uncover the symptom-level interconnections among nomophobia, SNS addiction, FoMO, and their links to mental health outcomes. A total of 3108 college students completed validated scales measuring SNS addiction, FoMO, nomophobia, anxiety, and depression. Gaussian graphical models and centrality indices were used to estimate symptom networks. Flow networks were constructed to identify pathways connecting symptoms to mental health outcomes. Strong intranetwork associations were found within all three domains. “FoMO on information” emerged as the most central and influential bridge symptom, connecting nomophobia and SNS addiction. Flow network analysis revealed that “FoMO on information” was also the strongest individual predictor of both anxiety and depression. Other symptoms, such as “fear of losing internet connection” and “SNS-related insomnia,” also showed notable associations with mental health outcomes. These findings highlight the potential of network and flow analysis to identify transdiagnostic mechanisms across digital behavioral addictions. “FoMO on information” appears to be a key symptom linking nomophobia and SNS addiction and may represent a promising target for interventions aimed at reducing comorbid anxiety and depression among adolescents.

Keywords

anxiety / depression / fear of missing out / network analysis / nomophobia / social networking site addiction

References

[1] Alhaj, H., A. Muthana, A. Abdalla, M. Marouf, and N. Awad. 2024. “How Are FOMO and Nomophobia Linked to Symptoms of Depression, Anxiety and Stress Among University Students?” BJPsych Open 10, no. S1: S16–S17. https://doi.org/10.1192/bjo.2024.104.

[2] Al-Mamun, F., M. A. Mamun, M. M. Kaggwa, et al. 2025. “The Prevalence of Nomophobia: A Systematic Review and Meta-Analysis.” Psychiatry Research 349: 116521. https://doi.org/10.1016/j.psychres.2025.116521.

[3] Alt, D. 2015. “College Students' Academic Motivation, Media Engagement and Fear of Missing out.” Computers in Human Behavior 49: 111–119. https://doi.org/10.1016/j.chb.2015.02.057.

[4] Andreassen, C. S., and S. Pallesen. 2014. “Social Network Site Addiction—An Overview.” Current Pharmaceutical Design 20, no. 25: 4053–4061. https://doi.org/10.2174/13816128113199990616.

[5] Anshari, M., Y. Alas, and E. Sulaiman. 2019. “Smartphone Addictions and Nomophobia Among Youth.” Vulnerable Children & Youth Studies 14, no. 3: 242–247. https://doi.org/10.1080/17450128.2019.1614709.

[6] Beyens, I., E. Frison, and S. Eggermont. 2016. ““I Don't Want to Miss a Thing”: Adolescents' Fear of Missing out and Its Relationship to Adolescents' Social Needs, Facebook Use, and Facebook Related Stress.” Computers in Human Behavior 64: 1–8. https://doi.org/10.1016/j.chb.2016.05.083.

[7] Borsboom, D. 2017. “A Network Theory of Mental Disorders.” World Psychiatry 16, no. 1: 5–13.

[8] Borsboom, D., and A. O. J. Cramer. 2013. “Network Analysis: An Integrative Approach to the Structure of Psychopathology.” Annual Review of Clinical Psychology 9: 91–121. https://doi.org/10.1146/annurev-clinpsy-050212-185608.

[9] Bragazzi, N. L., T. S. Re, and R. Zerbetto. 2019. “The Relationship Between Nomophobia and Maladaptive Coping Styles in a Sample of Italian Young Adults: Insights and Implications From a Cross-Sectional Study.” JMIR Mental Health 6, no. 4: e13154. https://doi.org/10.2196/13154.

[10] Bringmann, L. F., T. Elmer, S. Epskamp, et al. 2019. “What Do Centrality Measures Measure in Psychological Networks?” Journal of Abnormal Psychology 128, no. 8: 892–903. https://doi.org/10.1037/abn0000446.

[11] Bringmann, L. F., N. Vissers, M. Wichers, et al. 2013. “A Network Approach to Psychopathology: New Insights Into Clinical Longitudinal Data.” PLoS One 8, no. 4: e60188. https://doi.org/10.1371/journal.pone.0060188.

[12] Caba-Machado, V., J. M. Machimbarrena, A. Díaz-López, D. Sevilla-Fernández, C. Pérez-Sancho, and J. González-Cabrera. 2024. “Nomophobia Questionnaire Short-Form: Psychometric Properties and Longitudinal Association With Anxiety, Stress, and Depression in Adolescents.” International Journal of Human-Computer Interaction 40: 4585–4595. https://www.tandfonline.com/doi/abs/10.1080/10447318.2023.2215626.

[13] Chao, M., J. Lei, R. He, Y. Jiang, and H. Yang. 2023. “TikTok Use and Psychosocial Factors Among Adolescents: Comparisons of Non-Users, Moderate Users, and Addictive Users.” Psychiatry Research 325: 115247. https://doi.org/10.1016/j.psychres.2023.115247.

[14] Cheever, N. A., L. D. Rosen, M. Jimenez, J. Franco, and L. M. Carrier. 2021. “Nomophobia Impacts Physiological Arousal of Moderate and Heavy Smartphone Users Who Are Not Allowed to Access Text Messages During a Cognitive Task.” International Journal of Humanities and Social Science 11, no. 7: 6–13.

[15] Chen, I.-H., A. H. Pakpour, H. Leung, et al. 2020. “Comparing Generalized and Specific Problematic Smartphone/Internet Use: Longitudinal Relationships Between Smartphone Application-Based Addiction and Social Media Addiction and Psychological Distress.” Journal of Behavioral Addictions 9: 410–419. https://doi.org/10.1556/2006.2020.00023.

[16] Crusius, J., K. Corcoran, and T. Mussweiler. 2022. Social Comparison: Theory, Research, and Applications. https://doi.org/10.1002/9781394266616.ch7. (165–187).

[17] Dai, R., and L. Kong. 2022. “Positive Self-Presentation and Subjective Well-Being: The Suppression Effect of Social Network Addiction.” Advances in Psychology 12, no. 6: 6. https://doi.org/10.12677/AP.2022.126244.

[18] Elhai, J. D., J. C. Levine, R. D. Dvorak, and B. J. Hall. 2016. “Fear of Missing out, Need for Touch, Anxiety and Depression Are Related to Problematic Smartphone Use.” Computers in Human Behavior 63: 509–516. https://doi.org/10.1016/j.chb.2016.05.079.

[19] Epskamp, S., D. Borsboom, and E. I. Fried. 2018. “Estimating Psychological Networks and Their Accuracy: A Tutorial Paper.” Behavior Research Methods 50, no. 1: 195–212. https://doi.org/10.3758/s13428-017-0862-1.

[20] Epskamp, S., A. O. Cramer, L. J. Waldorp, V. D. Schmittmann, and D. Borsboom. 2012. “Qgraph: Network Visualizations of Relationships in Psychometric Data.” Journal of Statistical Software 48, no. 4: 1–18. https://doi.org/10.18637/jss.v048.i04.

[21] Gaber Hamzaa, H., M. H. R. Atta, M. Elghareap Hassan Elmetwally Omar, E. Reda Fathy Abdel Majeed Machaly, S. Mohamed Amin, and N. Mohamed Ibrahim Wahba. 2024. “Examining Nursing Students' Prevalence of Nomophobia, and Psychological Alienation and Their Correlates With Fear of Missing out: A Multisites Survey.” SAGE Open Nursing 10: 1–17. http://doi.org/10.1177/23779608241301223.

[22] Guo, S., X. Zou, Y. Tao, Y. Lv, X. Liu, and S. Huang. 2025. “Gender Differences in Symptom Interactions Between Problematic Smartphone Use and Social Anxiety in Adolescents: A Network Analysis.” Child and Adolescent Psychiatry and Mental Health 19, no. 1: 9. https://doi.org/10.1186/s13034-025-00865-w.

[23] Hashemi, Y., K. Borhani, M. Heidari, M. Esfahani, and F. Zarani. 2023. “Analysis of the Relationship Between Social Networking Site (SNS) Addiction and Nomophobia in Iranian Higher Education Students.” Iranian Journal of Health Sciences 11, no. 2: 117. https://doi.org/10.32598/ijhs.11.2.927.1.

[24] Hoşgör, H., and D. Gündüz Hoşgör. 2019. “The relationship among nomophobia, fear of missing out and demographic variables: Example of the healthcare manager candidates.” Current Addiction Research 3, no. 1: 16–24. https://doi.org/10.5455/car.105-1562758780.

[25] Jones, P. J., R. Ma, and R. J. McNally. 2021. “Bridge Centrality: A Network Approach to Understanding Comorbidity.” Multivariate Behavioral Research 56, no. 2: 353–367. https://doi.org/10.1080/00273171.2019.1614898.

[26] Kardefelt-Winther, D. 2014. “A Conceptual and Methodological Critique of Internet Addiction Research: Towards a Model of Compensatory Internet Use.” Computers in Human Behavior 31: 351–354. https://doi.org/10.1016/j.chb.2013.10.059.

[27] Kaviani, F., B. Robards, K. L. Young, and S. Koppel. 2020. “Nomophobia: Is the Fear of Being Without a Smartphone Associated With Problematic Use?” International Journal of Environmental Research and Public Health 17, no. 17: 17. https://doi.org/10.3390/ijerph17176024.

[28] Keles, B., N. McCrae, and A. Grealish. 2020. “A Systematic Review: The Influence of Social Media on Depression, Anxiety and Psychological Distress in Adolescents.” International Journal of Adolescence and Youth 25, no. 1: 79–93.

[29] Kroenke, K., R. L. Spitzer, and J. B. Williams. 2001. “The PHQ-9: Validity of a Brief Depression Severity Measure.” Journal of General Internal Medicine 16, no. 9: 606–613.

[30] Kuscu, T. D., F. Gumustas, A. Rodopman Arman, and M. Goksu. 2021. “The Relationship Between Nomophobia and Psychiatric Symptoms in Adolescents.” International Journal of Psychiatry in Clinical Practice 25, no. 1: 56–61. https://doi.org/10.1080/13651501.2020.1819334.

[31] Kuss, D. J., and M. D. Griffiths. 2011. “Online Social Networking and Addiction—A Review of the Psychological Literature.” International Journal of Environmental Research and Public Health 8, no. 9: 9. https://doi.org/10.3390/ijerph8093528.

[32] Kuss, D. J., and M. D. Griffiths. 2017. “Social Networking Sites and Addiction: Ten Lessons Learned.” International Journal of Environmental Research and Public Health 14, no. 3: 311.

[33] Kwon, M., D.-J. Kim, H. Cho, and S. Yang. 2013. “The Smartphone Addiction Scale: Development and Validation of a Short Version for Adolescents.” PLoS One 8, no. 12: e83558. https://doi.org/10.1371/journal.pone.0083558.

[34] Li, Q., J. Wang, S. Zhao, and Y. JlA. 2019. “Validity and Reliability of the Chinese Version of the Fear of Missing out Scale in College Students.” Chinese Mental Health Journal 33, no. 4: 6. https://doi.org/10.3969/j.issn.1000-6729.2019.04.014.

[35] Li, Y. Y., I. M. Koning, C. Finkenauer, M. Boer, and R. van den Eijnden. 2024. “The Bidirectional Relationships Between Fear of Missing Out, Problematic Social Media Use and Adolescents’ Well-Being: A Random Intercept Cross-Lagged Panel Model.” Computers in Human Behavior 154: 1–9.

[36] Lin, C.-Y., M. N. Potenza, M. Ulander, et al. 2021. “Longitudinal Relationships Between Nomophobia, Addictive Use of Social Media, and Insomnia in Adolescents.” Health 9, no. 9: 1201. https://doi.org/10.3390/healthcare9091201.

[37] Lin, L. y., J. E. Sidani, A. Shensa, et al. 2016. “Association Between Social Media Use and Depression Among U.S. Young Adults.” Depression and Anxiety 33, no. 4: 323–331. https://doi.org/10.1002/da.22466.

[38] Lin, Y.-C., and P.-C. Huang. 2025. “Digital Traps: How Technology Fuels Nomophobia and Insomnia in Taiwanese College Students.” Acta Psychologica 252: 104674. https://doi.org/10.1016/j.actpsy.2024.104674.

[39] Liu, X., T. Liu, Z. Zhou, and F. Wan. 2023. “The Effect of Fear of Missing out on Mental Health: Differences in Different Solitude Behaviors.” BMC Psychology 11, no. 1: 141. https://doi.org/10.1186/s40359-023-01184-5.

[40] Lu, X., L. Zhang, and Y. Tao. 2025. “The Role of Self-Control in the Bidirectional Relation Between Problematic Smartphone Use and Generalized Anxiety Symptoms Among Depressed Secondary School Students: Insight From Longitudinal Moderation Network Analysis.” Journal of Affective Disorders 391: 119981. https://doi.org/10.1016/j.jad.2025.119981.

[41] Maghaireh, D. F. A. L., N. S. Shawish, A. M. A. Kamel, and M. Kawafha. 2025. “Acute Nomophobia and Its Psychological Correlates in Adolescents: An Explanatory Sequential Mixed-Methods Approach.” Journal of Multidisciplinary Healthcare 18: 1445–1460. https://doi.org/10.2147/JMDH.S505535.

[42] Mail Online. 2008. “Nomophobia Is the Fear of Being Out of Mobile Phone Contact—And It's the Plague of Our 24/7 Age.” Mail Online. https://www.dailymail.co.uk/news/article-550610/Nomophobia-fear-mobile-phone-contact--plague-24-7-age.html.

[43] Milošević-Đorđević, J. S., and I. L. Žeželj. 2014. “Psychological Predictors of Addictive Social Networking Sites Use: The Case of Serbia.” Computers in Human Behavior 32: 229–234. https://doi.org/10.1016/j.chb.2013.12.018.

[44] Milyavskaya, M., M. Saffran, N. Hope, and R. Koestner. 2018. “Fear of Missing out: Prevalence, Dynamics, and Consequences of Experiencing FOMO.” Motivation and Emotion 42, no. 5: 725–737. https://doi.org/10.1007/s11031-018-9683-5.

[45] Niu, H., S. Wang, Y. Tao, Q. Tang, L. Zhang, and X. Liu. 2023. “The Association Between Online Learning, Parents' Marital Status, and Internet Addiction Among Adolescents During the COVID-19 Pandemic Period: A Cross-Lagged Panel Network Approach.” Journal of Affective Disorders 333: 553–561. https://doi.org/10.1016/j.jad.2023.04.096.

[46] Opsahl, T., F. Agneessens, and J. Skvoretz. 2010. “Node Centrality in Weighted Networks: Generalizing Degree and Shortest Paths.” Social Networks 32, no. 3: 245–251. https://doi.org/10.1016/j.socnet.2010.03.006.

[47] Przybylski, A. K., K. Murayama, C. R. DeHaan, and V. Gladwell. 2013. “Motivational, Emotional, and Behavioral Correlates of Fear of Missing out.” Computers in Human Behavior 29, no. 4: 1841–1848. https://doi.org/10.1016/j.chb.2013.02.014.

[48] R Core Team. 2023. “R: A Language and Environment for Statistical Computing.” In R Foundation for Statistical Computing. https://www.R-project.org/.

[49] Ranjan, L., P. Gupta, M. Srivastava, and N. Gujar. 2021. “Problematic Internet Use and Its Association With Anxiety Among Undergraduate Students.” Asian Journal of Social Health and Behavior 4: 137–141. https://doi.org/10.4103/shb.shb_30_21.

[50] Ren, S., G. Guli, and T. Liu. 2020. “Revisement of Nomophobia Scale for Chinese.” Psychological Exploration 40, no. 3: 7.

[51] Roberts, J. A., and M. E. David. 2020. “The Social Media Party: Fear of Missing out (FoMO), social Media Intensity, Connection, and Well-Being.” International Journal of Human-Computer Interaction 36, no. 4: 386–392. https://doi.org/10.1080/10447318.2019.1646517.

[52] Ryan, R., and E. Deci. 2000. “Self-Determination Theory and the Facilitation of Intrinsic Motivation, Social Development, and Well-Being.” American Psychologist 55: 68–78. https://doi.org/10.1037/0003-066X.55.1.68.

[53] Spitzer, R. L., K. Kroenke, J. B. W. Williams, and B. Löwe. 2006. “A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7.” Archives of Internal Medicine 166, no. 10: 1092–1097. https://doi.org/10.1001/archinte.166.10.1092.

[54] Tandon, A., A. Dhir, I. Almugren, G. N. AlNemer, and M. Mäntymäki. 2021. “Fear of Missing out (FoMO) Among Social Media Users: A Systematic Literature Review, Synthesis and Framework for Future Research.” Internet Research 31, no. 3: 782–821. https://doi.org/10.1108/INTR-11-2019-0455.

[55] Tang, Q., X. He, L. Zhang, X. Liu, Y. Tao, and G. Liu. 2023. “Effects of Neuroticism on Differences in Symptom Structure of Life Satisfaction and Depression-Anxiety Among College Students: A Network Analysis.” Behavioral Science 13, no. 8: 641. https://doi.org/10.3390/bs13080641.

[56] Tao, Y., H. Niu, Q. Tang, et al. 2024. “The Association Between Online Learning, Perceived Parental Relationship, Anxiety, and Depression Symptoms Among Secondary School Students: Insight From Symptom Network and Cross-Lagged Panel Network Approach.” BMC Public Health 24, no. 1: 2133. https://doi.org/10.1186/s12889-024-19675-4.

[57] Tao, Y., Q. Tang, X. Zou, et al. 2023. “The Impact of Long-Term Online Learning on Internet Addiction Symptoms Among Depressed Secondary School Students: Insights From a Cross-Panel Network Analysis.” Behavioral Science 13, no. 7: 520. https://doi.org/10.3390/bs13070520.

[58] Tao, Y., S. Wang, Q. Tang, Z. Ma, L. Zhang, and X. Liu. 2023. “Centrality Depression-Anxiety Symptoms Linked to Suicidal Ideation Among Depressed College Students—A Network Approach.” PsyCh Journal 12, no. 5: 735–745. https://doi.org/10.1002/pchj.668.

[59] Tao, Y., X. Zou, Q. Tang, et al. 2024. “Mapping Network Connection and Direction Between Anxiety and Depression Symptoms Across the Early, Middle, and Late Adolescents: Insights From a Large Chinese Sample.” Journal of Psychiatric Research 169: 174–183. https://doi.org/10.1016/j.jpsychires.2023.11.035.

[60] Thompson, A. 2024. “Digital 2024: 5 Billion Social Media Users.” We Are Social China. https://wearesocial.com/cn/blog/2024/01/digital-2024-5-billion-social-media-users/.

[61] Tung, S. E. H., W. Y. Gan, W. C. Poon, et al. 2025. “The Mediating Effect of Nomophobia in the Relationship Between Problematic Social Media Use/Problematic Smartphone Use and Psychological Distress Among University Students.” Psychology, Health & Medicine 30, no. 7: 1409–1425. https://doi.org/10.1080/13548506.2025.2478516.

[62] Vagka, E., C. Gnardellis, A. Lagiou, and V. Notara. 2023. “Prevalence and Factors Related to Nomophobia: Arising Issues Among Young Adults.” European Journal of Investigation in Health, Psychology and Education 13, no. 8: 1467–1476. http://doi.org/10.3390/ejihpe13080107.

[63] Vansteenkiste, M., R. M. Ryan, and B. Soenens. 2020. “Basic Psychological Need Theory: Advancements, Critical Themes, and Future Directions.” Motivation and Emotion 44, no. 1: 1–31. https://doi.org/10.1007/s11031-019-09818-1.

[64] Vogel, E. A., J. P. Rose, L. R. Roberts, and K. Eckles. 2014. “Social Comparison, Social Media, and Self-Esteem.” Psychology of Popular Media Culture 3, no. 4: 206–222. https://doi.org/10.1037/ppm0000047.

[65] Wang, J., N. Wang, P. Liu, and Y. Liu. 2025. “Social Network Site Addiction, Sleep Quality, Depression and Adolescent Difficulty Describing Feelings: A Moderated Mediation Model.” BMC Psychology 13, no. 1: 57. https://doi.org/10.1186/s40359-025-02372-1.

[66] Wen, J., Y. Huang, G. Liu, and M. Miao. 2023. “The Nature of Nomophobia and Its Associations With Contents of Smartphone Use and Fear of Missing out: A Network Perspective.” Telematics and Informatics 82: 102011. https://doi.org/10.1016/j.tele.2023.102011.

[67] Xiao, Y., Y. Meng, T. T. Brown, K. M. Keyes, and J. J. Mann. 2025. “Addictive Screen Use Trajectories and Suicidal Behaviors, Suicidal Ideation, and Mental Health in US Youths.” JAMA 334: e257829. https://doi.org/10.1001/jama.2025.7829.

[68] Xu, H., Y. Wu, X. Cong, et al. 2025. “Identifying and Simulating Interventions on Central Depressive Symptoms: A Network Analysis Combining Clinical and Sub-Clinical Samples.” Journal of Affective Disorders 394: 120602. https://doi.org/10.1016/j.jad.2025.120602.

[69] Yildirim, C., and A.-P. Correia. 2015. “Exploring the Dimensions of Nomophobia: Development and Validation of a Self-Reported Questionnaire.” Computers in Human Behavior 49: 130–137. https://doi.org/10.1016/j.chb.2015.02.059.

[70] Yılmaz, T., and E. Bekaroğlu. 2022. “Does Interpersonal Sensitivity and Paranoid Ideation Predict Nomophobia: An Analysis With a Young Adult Sample.” Current Psychology 41, no. 2: 1026–1032. https://doi.org/10.1007/s12144-021-01501-4.

[71] Zhu, X., W. Lian, and L. Fan. 2024. “Network Analysis of Internet Addiction, Online Social Anxiety, Fear of Missing out, and Interpersonal Sensitivity Among Chinese University Students.” Depression and Anxiety 2024: 5447802. https://doi.org/10.1155/2024/5447802.

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