Despina Stavrinos et al.1 alerts us to an area of concern arising
from cell phone usage among children. Increasing numbers of our pediatric
patients are using cell phones. More importantly, perhaps, is the issue of
cell phone text messaging misuse or textopathy.
The cell phone text messaging (texting) is a multimedia phenomenon
including text, picture and sound. It is facilitated by cheap, small, and
mobile hardware with increasingly improved keyboards and touch screen
technology. With the increasing popular “unlimited” text messaging service
plans there is no longer financial incentive for limiting use. All this is
rapidly being amplified by social networking and micro blog phenomena such
as Twitter. Texting can occur in secret with all messages easily erased
making parental surveillance challenging. The above makes this digital
technology similar yet in a separate class of misuse from computer-
internet based activities.
Less than a year ago a Nielsen group survey2 showed that cell phone
text messaging to be increasing at a rapid rate, with an increase of 450%
between 2006 and 2008 . More importantly, by far the highest usage was
among the 13-17 age group. It is not uncommon for my teen patients to
report texting tens of thousands of messages a month. This translates to
two or more hours sending and viewing received messages each day.
Physicians caring for adolescents should be aware of this activity and its
potential physical and psychosocial sequelae.
As a label for these sequelae, the term “compulsive-impulsive spectrum
disorder” was proposed in an editorial in the American Journal of
Psychiatry3. However the discussion was mostly about e-mail “addiction”,
supported by disturbing data from South Korea. This psychiatric labeling
is incomplete as it does not cover the entire spectrum of difficulties
reported for cell phone text messaging misuse. In search for a simple
term that would be fitting with the culture of the issue being discussed,
I consulted a biomedical naming expert4 and so the origin of “textopathy”.
The spectrum of textopathy includes the following:
1. Content abuse: This includes cyber bullying5,6(bullying through
the use of technology such as the internet and cellular phones) and
sexting 7(the transmission of nude photographs via a cell phone).
2. Decreased situation awareness: resulting in increased injury risk
in pedestrians and drivers8.
3. Time mismanagement: texting during class, meals, and social
gatherings. Sending and receiving texts through the night (See below).
Misuse of available time for other activities.
4. Behavioral disturbance: anxiety, dependency and frank addiction3.
5. Miscellaneous concerns: such as excessive exposure to
electromagnetic fields9
My current research looks at texting as a cause of sleep deprivation.
Preliminary data from a survey of high school students is showing that 50-
60% leave their cell phone on to receive and send texts throughout the
night and as much as 10% of this group report being tired in the morning
due to texting.
I have no doubt that the above spectrum of textopathy will prove to be
incomplete as we become more aware of other ill effects of this rapidly
developing phenomenon. Pediatricians and parents will be increasingly
challenged to keep up with this potential misuse and its ramifications.
References:
1 Despina Stavrinos, Katherine W. Byington, and David C. Schwebel
Effect of Cell Phone Distraction on Pediatric Pedestrian Injury Risk
Pediatrics feb 2009;123:e179185
2
http://www.nielsenmobile.com/html/press%20releases/TextsVersusCalls.html
3 : Jerald J. Block Issues for DSM-V: Internet Addiction .Am J
Psychiatry 2008 165: 306-307
4 : Richard Bragdon-Idiom; 708 Montgomery St, San Francisco, CA 94111
-2104
5 David-Ferdon C, Hertz MF: Electronic media, violence, and
adolescents: an emerging public health problem. J Adolesc Health 2007; 41
(suppl1):S1-S5.
6 Robin M. Kowalski, Ph.D., Susan P. Limber, Ph.D., and Patricia W.
Agaston, Ph.D. Malden Mass Cyber Bullying; Bullying in the Digital Age.
Blackwell, 2008.
7 Dahlia Lithwick. Teens, nude photos and the law. Newsweek February
23, 2009:page 18.
8 Kenneth R Ginsburg, Flaura K. Winston, Teresa M. Senserrick et al.
National young-driver survey: teen perspective and experience with factors
that affect driving safety. Pediatrics May 2008; 121 e1391-e1403
9 Leeka Kheiferts, Michael Repacholi, Rick Saunders et al :The
sensitivity of children to electromagnetic fields Pediatrics August 2005
116; e303-e313
Conflict of Interest:
None declared
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