Relationship between Life Stress, Depression and Smartphone addiction in Nursing Students: Mediating Effects of Experiential Avoidance

간호대학생의 생활스트레스가 우울과 스마트폰 중독에 미치는 영향: 경험회피의 매개효과

  • Received : 2017.05.12
  • Accepted : 2017.07.07
  • Published : 2017.07.31


The purpose of this study was to examine the mediating effects of experiential avoidance on the relationships between life stress, depression and smartphone addiction in nursing college students. This study was conducted using a descriptive survey design. Participants were 283 nursing college students attending freshmen and sophomore yearsat one university in Jeollanam-do. Data were collected from September 1 to 15, 2015 using self-report questionnaires. Data were analyzed using descriptive statistics, Pearson's correlation coefficient, hierarchical regression and Sobel test with SPSS 21.0. There were significant positive correlations between life stress, depression, smartphone addiction and experiential avoidance. Experiential avoidance partially mediated the relationship between life stress and depression of nursing students. Additionally, experiential avoidance partially mediated the relationship between their life stress and smartphone addiction. The results show that experiential avoidance plays a key role in psychopathology and grows with depression and smartphone addiction. Based on the present findings, nursing interventions should be developed to decrease experiential avoidance, with additional consideration towards the relationship between life stress and experiential avoidance, in order to prevent depression and smartphone addiction among nursing college students.


Depression;Experiential avoidance;Life stress;Nursing students;Smartphone addiction


  1. K. K. Chon, K. H. Kim, "Development of the revised life stress scale for college students", The Korean Journal of Clinical Psychology, vol. 10, no. 1, pp. 137-158, 1991.
  2. E. H. Lee, "Life stress and depressive symptoms among college students: testing for moderating effects of coping style with structural equations", Korean Journal of Health Psychology, vol. 9, no. 1, pp. 25-48, 2004.
  3. S. K. Cha, E. M.. Lee, "Comparison of stress, depression and suicidal ideation between nursing students and students of other majors", The Journal of Korean Academic Society of Nursing Education, vol. 20, no. 4, pp. 650-658, 2014. DOI:
  4. C. B. Shriver, A. Scott-Stilles. Health habits of nursing versus non nursing students: a longitudinal study", Journal of Nursing Education, vol. 39, no.7, pp. 308-314, 2000.
  5. N. Shelds, "Stress, active coping, and academic performance among persisting and nonpersisting students", Journal of Applied Biobehavioral Research, vol. 6, no. 2, pp. 65-81, 2001. DOI:
  6. S. J. Gong, E. H. Lee, "Mediation effect of coping between life stress and depression in female college students", The Korean Journal of Woman Psychology, vol. 11, no. 1, pp. 21-40, 2006.
  7. K. H. Park. "Development of a structural equation model to estimate university students' depression", Journal of Korean Academy of Nursing, vol. 38, no. 6, pp. 779-788, 2008. DOI:
  8. J. K. Park, J. K. Kim. "The effects of life stress on university student's suicide and depression: focusing on the mediating pathway of family and friend's support", Korean journal of youth studies, vol. 21, no. 1, pp. 167-189, 2014.
  9. F. L. Vázquez, V. Blanco. "Prevalence of DSM-IV major depression among Spanish university students" Journal of American College Health, vol. 57, no. 2, pp. 165-172, 2008. DOI:
  10. M. S. Roh, H. G. Jeon, H. W. Lee, H. J. Lee, S. K. Han, B. J. Hahm. "Depressive disorders among the college students: Prevalence, risk factors, suicidal behaviors and dysfunctions", Journal of Korean Neuropsychiatry Association, vol. 45, no. 5, pp. 432-437, 2006.
  11. M. K. Shin, H. R. Yi, J. S. Won. "Influence of life stress and depression on suicidal ideation among college nursing students", Journal of Korean Academy of Fundamentals of Nursing, vol. 20, no. 4, pp. 419-428, 2013. DOI:
  12. S. H. Shin. "The effect of academic stress and the moderating effects of academic resilience on nursing students' depression", The Journal of Korean Academic Society of Nursing Education, vol. 22, no. 1, pp. 14-24, 2016. DOI:
  13. E. S. Lee. "Impact of Life Stress on Depression, Subjective Well-being and Psychological Well-being in Nursing Students: Mediation Effects of Coping", Journal of the Korea Academia-Industrial cooperation Society, vol. 18, no. 1, pp. 55-65, 2017. DOI:
  14. H. S. Jeon, S. O. Jang. "A study on the influence of depression and stress on smartphone addiction among university students: focused on moderating effect of gender" Korean journal of youth studies, vol. 21, no. 8, pp. 103-129, 2014.
  15. S. R. Jung. "The effect of female university students' stress about campus life has on Smartphone addiction: the mediating effect of depression" Unpublished Master's Thesis, Seoul Women's University, Seoul, 2014.
  16. M. Y. Sim, D. N. Lee, E. H. Kim "A study on influential relations between stress and smartphone addiction among college students: with a focus on the mediating effects of depression and self-Efficacy", Journal of the Korea Academia-Industrial cooperation Society, vol. 17, no. 5, pp. 227-336, 2016. DOI:
  17. C. Blanco, M. Okuda, C. Wright, D. Hasin, B. Grant, S. Liu, "Mental health of college students and their non-college attending peers", Archives of General Psychiatry, vol. 65, pp. 429-437, 2008. DOI:
  18. J. Y. Yun, J. S. Moon, M. J. Kim, Y. J. Kim, H. A. Kim, B. U. Huh et al. "Smartphone addiction and health problem in university student. Journal of Korean association for Crisis and Emergency Management, vol. 3, no. 2, pp. 92-104, 2011.
  19. S. H. Lee. "Structural equation model on smartphone addiction in nursing students" Unpublished doctoral dissertation, InJe University, Pusan, 2016.
  20. S. Y. Choo, S. M. Lim. "The relationship between life stress and depression in undergraduates: the mediating effect of experimental avoidance and the moderating effect of problem-focused coping", Korean journal of youth studies, vol. 17, no. 2, pp. 309-332, 2010.
  21. B. N. R. Kim. "the relations between academic stress and smartphone addiction: dual mediating effects of anxiety and experimental avoidance", Unpublished Master's Thesis, Catholic University, Seoul, 2014.
  22. S. C. Hayes, J. B. Luoma, F.W. Bond, A. Masuda. & J. Lillis, "Acceptance and commitment therapy: model, processes and outcomes. Behavior Research and Therapy, vol. 44, pp. 1-25, 2006. DOI:
  23. K. K. Chon, K. H. Kim, J. S. Lee, "Development of the revised life stress scale for college students", Korean Journal of Health Psychology, vol. 5, no. 2, pp. 316-335, 2000.
  24. S. C. Hayes, K. Strosahl, K. G. Wilson, R. T. Bissett, J. Pistorello, D. Toarmino, M. A. Polusny, et al. "Measuring experiential avoidance: a preliminary test of a working model", Psychological Record, vol. 54, pp. 553-78, 2004.
  25. F. W. Bond, S. C. Hayes, R. A. Baer, K. M. Carpenter, N. Guenole, H. K. Orcutt, T. Waltz, R. D. Zettle. "Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: a revised measure of psychological inflexibility and experiential avoidance" Behavioral Therapy, vol. 42, no. 4, pp. 676-688, 2011. DOI:
  26. J. H. Heo, M. S. Choi, H. J. Jin. "Study on the Reliability and Validity of Korean Translated Acceptance-Action Questionnaire-2", Korean Journal Of Counseling And Psychotherapy, vol. 21, no. 4, pp. 861-878, 2009.
  27. K. K. Chon, S. C. Choi, B. C. Yang, "Integrated adaptation of CES-D in Korea", The Korean Journal of Health Pychology, vol. 6, no. 1, pp. 59-76, 2001.
  28. National Information Society Agency, "Development of Korean Smartphone Addiction Proneness Scale For Youth and Adults", 2011.
  29. R. M. Baron, D. A. Kenny. "The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations", Journal of Personality and Social Psychology, vol. 51, pp. 1173-1182, 1986. DOI:
  30. N. Seyedfatemi, M. Tafreshi, H. Hafani. "Experienced stressors and coping strategies among iranian nursing students", BMC Nursing, vol. 6, pp. 1-11, 2007. DOI:
  31. G. Y. Cho, Y. H. Kim. "Factors affecting smartphone addiction among university students", Journal of the Korea Academia-Industrial cooperation Society, vol. 15, no. 3, pp. 1632-1640, 2014. DOI:
  32. S. Haug, R. P. Castro, M. Kwon, A. Filler, T. Kowatsch, M. P. Schaub. "Smartphone use and smartphone addiction among young people in switzerland", Journal of Behavioral Addictions, vol. 4, no. 4, pp. 299-307, 2015. DOI:
  33. H. Li, Y. Zou, J. Wang, X. Yang. "Role of stressful life events, avoidant coping styles, and neuroticism in online game addiction among college students: a moderated mediation model", Frontiers in Pshchology, vol. 7, pp. 1-11, 2016. DOI:
  34. S. C. Hayes, K. G. Wilson, E. V. Gifford, V. M. Follette, & K. Strosahl. "Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment" Journal of Consulting and Clinical Psychology, vol. 64, no. 6, pp. 1152-1168, 1996.
  35. J. M. Ha, C. N. Son. "Effects of acceptance and commitment therapy(ACT) on self-control, depression, and smartphone addiction level in university students with high level of depression and smartphone addiction", Korean Journal of Clinical Psychology, vol. 1, no. 1, pp. 1-16, 2016.
  36. H. G. Yu, C. N. Son. "Effects of ACT on smartphone addiction level, self-control, and anxiety of college students with smartphone addiction", Journal of Digital Convergence, vol. 14, no. 2, pp. 415-426, 2016. DOI:
  37. M. A. Cheon, E. J. Wang. "ACT based stress management counseling program for employees and its effectiveness in the workplace", Korea Journal of Counseling, vol. 15, no. 4, pp. 1403-1424, 2014. DOI:
  38. J. H. Lee, C. N. Son "The effects of the Acceptance-Commitment Group Therapy (ACT) on the self-control, psychological well-being, experiential avoidance and cognitive fusion in alcoholics", Korean Journal of Stress Research, vol. 21, no. 1, pp. 41-50, 2013. DOI:
  39. A. Biglan, S. C. Hayes. "Acceptance and commitment: implications for prevention science", Prevention Science, vol. 9, pp. 139-152, 2008. DOI: