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Leeds Thesis Template Investigating the associations between well-being and digital technology use in a UK university student population Azaria Louise Esmaielian Khyabani Submitted in accordance with the requirements for the degree of Doctor of Clinical Psychology (D. Clin. Psychol.) The University of Leeds School of Medicine Division of Psychological and Social Medicine June 2020 i The candidate confirms that the work submitted is her own and that appropriate credit has been given where reference has been made to the work of others. This copy has been supplied on the understanding that it is copyright material and that no quotation from the thesis may be published without proper acknowledgement. The right of Azaria Louise Esmaielian Khyabani to be identified as Author of this work has been asserted by her in accordance with the Copyright, Designs and Patents Act 1988. © 2020 The University of Leeds and Azaria Louise Esmaielian Khyabani i Acknowledgements Firstly, I would like to thank all the University of Leeds students who took the time to participate in this research; without which it would not have been possible. A particular thank you to Jeanette Youds for distributing my recruitment email to her many contacts at the university. I suspect my successful recruitment is largely thanks to you. To my supervisors. Dr Bridgette Bewick and Dr Tracey Farragher, thank you for your unwavering enthusiasm, wisdom, support, and humour. You have been fantastic supervisors and it has been my pleasure to work with you both. To the trainees in my DClin cohort, being surrounded by a group of such thoughtful, intelligent, hilarious, and supportive women has taught me so much. I will be forever grateful for the three years we have spent together in training and look forward to a lifetime of friendship. To my friends outside of training, thank you for reminding me that there is life beyond a doctorate. Special thanks to my closest friends, Katie Marlow and Rachel Oldroyd, for always offering your support, love and advice despite being busy with your own lives and doctoral studies. Your friendship is invaluable. To my family, there are not enough words to express my thanks to you. You have always believed in me and been so proud of everything I have done. Your love and support have been the foundations from which I have achieved my goals. Lastly but by no means least, thank you to my husband Adam. The majority of this thesis was written during the COVID-19 pandemic whilst we were in lockdown together and we still managed to laugh and have fun every day. You have been my number one supporter from the beginning and your love and encouragement (and knowledge of Excel) have got me through to the end. I could not have done this without you by my side. ii Abstract Introduction: Understanding and protecting the well-being of university students is of increasing importance to universities and support services. Problematic digital technology use has been associated with poorer student well-being internationally, but little is known about this relationship in the UK university student population. The current research investigated whether digital technology use and wellbeing are associated in the UK student population, which factors of well-being are important to this relationship and how they are associated with digital technology use. Method: Students from the University of Leeds (n = 544) completed an online survey composed of standardised measures of factors relating to psychological well-being, mental health, physical health and problematic digital technology use. Nine models were analysed using structural equation modelling. Theoretical relationships between well-being and digital technology use and moderating effects of basic psychological need satisfaction, social support and mental health were assessed, as well as the goodness of fit for each model. Results: The superior model, 5.0, hypothesised that greater problematic digital technology use would be associated with lower well-being. Mental health and basic psychological need satisfaction were hypothesised to moderate this relationship. In model 5.0, digital technology use was significantly negatively associated with well-being (β = -0.16, p < .01). Basic psychological need satisfaction did not moderate the relationship. Mental health moderated the relationship and was significantly negatively associated with well-being (β = -0.90, p < .001) and significantly positively associated with digital technology use (β = 0.26, p < .001). Discussion: Digital technology use is related to well-being in the UK university student population. Students with mental health difficulties are more likely to have a problematic relationship with digital technology and for their use of digital technology to negatively impact on their well-being. It is recommended that universities work to increase awareness of the impact of problematic technology use on well-being and its relationship with mental health difficulties. iii Table of Contents Acknowledgements ................................................................................................................ i Abstract .................................................................................................................................. ii List of Tables ........................................................................................................................ vi List of Figures ...................................................................................................................... vii Introduction ........................................................................................................................... 1 Defining well-being, psychological well-being and mental health ............................... 1 Defining well-being ............................................................................................. 2 Defining psychological well-being and mental health – the dual continuum model ................................................................................................................... 2 Why is the well-being of university students important? .............................................. 3 How does university student psychological well-being and mental health change over time? .................................................................................................. 5 Identifying terms for the degree of digital technology use and defining problematic use ............................................................................................................................. 6 Risk factors for problematic digital use ............................................................... 8 Understanding why people become addicted to digital technology: theories of digital technology use ................................................................................ 9 What do we know about when digital use becomes ‘problematic’ in the UK university student population? ................................................................. 11 What do we currently know about the relationship between digital use, well-being and mental health in general? ................................................................................... 12 What factors are associated with well-being in university students and how are they associated with digital technology use? ............................................................ 13 How does Mental Health impact on university student well-being? ................. 14 How does psychological well-being impact on university student well-being and mental health? .......................................................................................... 18 How does physical health impact on university student psychological well-being and mental health? ................................................................................... 24 What is the relationship between academic success and university student well- being and mental health? ......................................................................... 28 Summary of the literature outlined.............................................................................. 29 Systematic review ....................................................................................................... 31 Introducing the systematic search ..................................................................... 31 How is psychological well-being specifically associated with digital technology use in university students? ....................................................................... 34 iv Summary of the current research ................................................................................ 39 Method ................................................................................................................................. 40 Methodology ............................................................................................................... 40 Research Philosophy ......................................................................................... 40 Research design ................................................................................................. 40 Population and Sample ................................................................................................ 41 Inclusion / exclusion criteria ............................................................................. 41 Measures ....................................................................................................................
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