Wenjing Sun, Bing Yu, Meiling Zhang, Miao Pang, Yao Yan, Ya Wen, Chunhui Li, Mou Wang, Wei Zhang, Yinglin Chu
The findings identify cross-sectional direct, indirect, and conditional associations consistent with the proposed theoretical framework. The small moderation effects should not be interpreted as evidence of substantial practical importance, and longitudinal studies are needed to evaluate temporal ordering and causality.
INTRODUCTION: Nomophobia (fear of being without a mobile phone) has emerged as a growing psychological concern in the digital era, negatively affecting the mental well-being and academic functioning of university students. Drawing on the Stimulus-Organism-Response (S-O-R) and Interaction of Person-Affect-Cognition-Execution (I-PACE) frameworks, this study examined the relationship between rumination and nomophobia, tested the sequential mediating roles of emotion dysregulation and interaction anxiousness, and explored the moderating effects of health literacy (HL) and digital health literacy (DHL).
METHODS: A cross-sectional survey using multistage stratified cluster sampling recruited 22,582 participants from five higher education institutions in Jilin Province, China, between June and December 2025. Participants completed the Ruminative Responses Scale (RRS), Difficulties in Emotion Regulation Scale (DERS-16), Interaction Anxiousness Scale (IAS), Nomophobia Questionnaire (NMP-Q), and measures of HL and DHL. An observed-variable path model and separate regression-based moderation analyses were used to examine the hypothesized associations.
RESULTS: Rumination was positively associated with nomophobia (β = 0.133, p < 0.001). Emotion dysregulation and interaction anxiousness showed statistically significant independent and sequential indirect associations. HL moderated the association between rumination and interaction anxiousness, and DHL moderated the association between emotion dysregulation and nomophobia; however, the interactions explained only 0.05% and 0.23% additional variance, respectively.
CONCLUSION: The findings identify cross-sectional direct, indirect, and conditional associations consistent with the proposed theoretical framework. The small moderation effects should not be interpreted as evidence of substantial practical importance, and longitudinal studies are needed to evaluate temporal ordering and causality.