Objective:

To examine the associations between problematic smartphone use (PSU), problematic gaming (PG), and disruptive behavioral disorders (DBDs) in Korean adolescents, considering parental and residential factors.

Approach:

• Data Source: Data were obtained from the 2022 Korean National Mental Health Survey of Children and Adolescents, focusing on adolescents aged 12–17 years.
• Analysis Method: Multivariable logistic regression models were used to analyze associations between PSU, PG, and DBDs.

Key Findings:

• Adolescents with PSU or PG showed significantly higher prevalence of all DBD subtypes (all p<0.01).
• PSU was associated with conduct disorder (CD) only in urban areas (OR=2.03, 95% CI=1.30–3.16).
• PG was more strongly associated with ADHD-inattentive symptoms in rural areas (rural: OR=4.22, 95% CI=2.15–8.30; urban: OR=2.10, 95% CI=1.49–2.96).
• The association between PSU and oppositional defiant disorder (ODD) was stronger among adolescents with highly educated mothers (OR=3.64 vs. 1.93).
• The PSU-CD link was evident only when fathers drank less frequently (OR=2.15, 95% CI=1.34–3.45).

Interpretation:

PSU and PG are associated with DBDs, with distinct patterns based on urban-rural residency and parental characteristics.

Limitations:

• The study's cross-sectional design limits causal inferences.
• Potential confounding factors were adjusted but may still influence results.

Conclusion:

If causal relationships are confirmed, targeted interventions may promote adolescent behavioral health.