Is Texting While Driving a Warning Sign or Risk Factor for Addiction?

There’s an interesting phenomenon in the field of mental health research that’s developed over the past fifteen years. We should clarify that. The phenomenon developed in a subfield of mental health research: addiction research.

The subject of the phenomenon we’re talking about goes by several names. Here are the thee most common:

• Cell phone addiction
• Internet addiction
• Social media addiction

That’s the subject.

Here’s the interesting phenomenon:

Many researchers talk about cell phone addiction, internet addiction, and social media addiction as if they’re well-established diagnoses accepted by the medical community in general, and the mental health treatment community specifically.

There’s a catch, though.

None of those three – cell phone, internet, or social media – appear as addictions or disorders in the Diagnostic and Statistical Manual of Mental Disorders, Volume 5 (DSM-5) or the International Classification of Diseases, Mental and Behavioral Disorders Section, Volume 11 (ICD-11). The DSM-V is the go-to diagnostic manual for mental health professionals in the U.S., while the ICD-11 is the go-to diagnostic manual for mental health professionals worldwide, approved and endorsed by the World Health Organization (WHO).

Nevertheless, a general internet search, or a query using search engines designed to generate results from peer-reviewed scientific journals, both produce a wide range of publications that discuss cell phone, internet, and social media addiction as if they were diagnoses as widely accepted as alcohol use disorder (AUD), substance use disorder (SUD), or non-addiction disorders such as major depressive disorder (MDD) or general anxiety disorder (GAD).

We need to set the record straight.

At the time of writing – June 2022 – there is no official diagnosis called cell phone, social media, or internet addiction in the DSM-V, the ICD-11, or any internet or social media related diagnosis recognized by the WHO or the American Medical Association (AMA).

Texting, Driving, Risky Behavior, and Addiction

The reason we’re writing this article is that while researching this topic, we found a thesis that connects – in theory – the dangerous practice of texting and driving with vulnerability to addiction. This prompted us to dig further, and consider the relationship of texting while driving with concepts often associated with clinical addiction disorders.

Let’s be clear though. Our goal is not to argue for or against including internet-related addictions in the DSM-V or the ICD-11. At the moment, the DSM-V is in the process of considering internet gaming disorder as a diagnosis, and has published preliminary criteria for the diagnosis – pending additional research that will help clarify any future diagnosis and eliminate confusion. From our point of view, that’s the correct approach: follow the data and evidence and ensure it supports any diagnosis that may eventually impact the lives of individuals and families.

In addition, this quote, attributed to write Amanda Heller of the Boston Globe and published in the article “Should DSM-V Designate “Internet Addiction” a Mental Disorder?” resonates with us:

“If every gratified craving from heroin to designer handbags is a symptom of ‘addiction,’ then the term explains everything and nothing.”

It resonates more clearly when we remind ourselves that we now have a new way of thinking of addictions: they’re now classified as mental health disorders that respond positively to an integrated treatment plan that includes psychotherapy, lifestyle changes, education, and in some cases, psychiatric medication.

That’s why, for instance, when we hear someone say “I’m totally addicted to my phone,” or “Omg I’m addicted to this app,” or “I’m addicted to [Facebook, Instagram, TikTok],” we’re fairly certain they don’t truly meet the criteria for a clinical mental health disorder.

What they mean is they use [fill in the blank] too much, and sometimes it might cause problems. For the rest of this article, we’ll discuss the practice of texting and driving in the context of risky behavior, with the goal of persuading parents and teens that although cell phone, social media, and internet use disorders are not clinical diagnoses, the practice of texting and driving overlaps with elements of clinical behavioral disorders like AUD and SUD, and has the potential to be as dangerous as any addiction disorder we know about.

Texting and Driving: Facts and Figures

We all know texting and driving is a “terrible, horrible, no good, very bad” idea on every level imaginable. We collected the following statistics on the prevalence and dangers of texting while driving – a.k.a. distracted driving – from three reliable and reputable sources:

1. MORE FACTS ABOUT TEEN DISTRACTED DRIVING published by the Children’s Hospital of Philadelphia Research Institute
2. A publication called Traffic Safety Facts: Distracted Driving 2019 released by the National Highway and Traffic Safety Administration
3. An article called Taking on Distracted Driving published by the Federal Highway Administration

This is a long list, so get ready.

Accidents and Deaths Involving Texting and Driving Distracted

• In 2015:
  • 391,000 people were injured in car accidents involving distracted driving
  • 3,196 people died in car accidents involving distracted driving
• In 2018:
  • 400,000 people were injured in car accidents involving distracted driving
  • 2,800 people died in car accidents involving distracted driving
• In 2019:
  • 424,000 people were injured in car accidents involving distracted driving
  • 3,142 died in car accidents involving distracted driving

Next, we’ll look at how texting while driving affects driving.

Texting and Driving: How it Affects Driving

• Cell phone use behind the wheel reduces attention on the act of driving by 37%
• Texting while driving:
  • Reduces ability to focus on the road
  • Impairs ability to respond to traffic circumstance
  • Reduces ability control a vehicle within a lane
  • Impairs ability to control a vehicle in space with respect to other vehicles
• Texting while driving is associated with:
  • 9% of fatal crashes
  • 15% of crashes involving injury
  • 15% of all crashes for which a police report was filed
• Texting and driving causes 1.6 million crashes each year
• People who text while driving are 23 times more likely to have an accident
• When a driver looks away from the roadway, the chances of an accident increase by 400%

Next, we’ll look at the prevalence of texting and driving.

Texting and Driving: How Many People Do It?

• Each year, an estimated 660,000 drivers attempt to use their phone while driving
• In 2019:
  • 39% of high school students said that in the past month, they’d either texted or emailed someone while driving
• 9% of drivers aged 15 to 20 years involved in fatal crashes were “reported a distracted”
  • The largest proportion of fatalities due to distracted driving occurred in this age group

We’ll finish this section with a series of additional important facts about texting and driving.

Texting and Driving: Associated Behaviors and Relevant Facts

• People age 18-24 who say they use their phone while driving say they also:
  • Regularly drive over the speed limit
  • Run red lights
  • Pass slower cars on the right
• High school students who say they regularly text while driving were:
  • Less likely to wear a seat belt
  • More likely to ride with a driver who had been drinking alcohol
  • More likely to drink and drive
• Cell phones can distract teens in many ways aside from texting, including:
  • Checking social media
  • Using video chat apps
  • Checking GPS
  • Finding/putting on music
• Teens diagnosed with attention-deficit hyperactivity disorder (ADHD) are 15% more likely to become distracted while driving than teens without an ADHD diagnosis

The point of all this information is twofold. First, we want to remind people that texting while driving is dangerous. Texting while driving kills. It’s the very definition of risky behavior. Teens know that and parents know that. Yet – as we can see above – that statistics say they 600,000 people a year text while they drive, and 39 percent of high school students text while they drive.

With regards to the teens, do they text and drive because they can’t stop using their phones?

The Possible Definition of and Criteria for Smartphone Addiction

In 2016, a group of researchers published a paper called “Proposed Diagnostic Criteria for Smartphone Addiction.” The goal of the publication was to codify and formalize the concept of smartphone addiction and create a set of inclusion or exclusion factors that parallel the current DSM-V and ICD-11 criteria for “substance related and addiction disorders.” The structure of their criteria mirrors those found in the DSM-V and ICD-11, which would make this category – if evidence supports it – relatively simple to place alongside existing addiction disorders.

Here’s how they defined the potential disorder:

Behavioral Criteria for Smartphone Addiction

Smartphone addiction would involve maladaptive pattern of smartphone use that lead to clinically relevant impairment or distress at any time during 3-month period. To meet criteria, at least three of the following symptoms must be present:

1. Failure to resist the impulse to use the smartphone
2. Irritability after a period without access to a smartphone
3. Using a smartphone for longer than intended
4. Unsuccessful attempts to quit or reduce smartphone use, despite the desire to stop using the smartphone
5. Excessive time spent on using smartphone, or trying to quit using the smartphone
6. Ongoing smartphone use despite knowledge of physical or psychological problems resulting from smartphone use

Functional Criteria for Smartphone Addiction

To meet functional criteria for smartphone addiction, at least three of the following must be present:

• Smartphone use that results in physical or psychological problems
• Smartphone use in a hazardous situation:
  • Smartphone use while driving
  • Smartphone use while crossing the street
  • Other negative impacts on daily life
• Smartphone use that impairs social relationships, school performance, or job performance
• Smartphone use causes significant subjective distress, or is time-consuming

Exclusion Criteria

• The behavior is not explained better by obsessive–compulsive disorder or by bipolar I disorder

We include all this here for two reasons. First, to point out that although we defer and refer to the DSM-V for all our criteria for making mental or behavioral health diagnoses, we understand why many mental health professionals are convinced smartphone addiction is real. Second, we include this information – in combination with the extensive bullet lists in the previous section – for parents to use when they establish their family rules around smartphone use.

Family Rules: No Texting and Driving

This is really what this entire article boils down to.

If you’re the parent of a teen, it’s critical to make sure your teen never texts and drives.

Not ever. Not once.

Refer to the statistics above: when people text and drive, cars crash, and people die.

That’s why parents have to set clear rules and expectations about texting and driving – and possibly go further. We’ll explain why after we share evidence from one more study on texting and driving.

A study published in Canada in May 2022 called “Teen Driver Distractions and Parental Norms” revealed a set of results that all parents of teens should know about. Here’s what they found:

• Teens who report high frequency of texting and driving think their parents text and drive with the same level of frequency they do
• Parents of teens who report high frequency of texting and driving themselves report a far lower frequency of texting and driving than their teens think they engage in
• Parents of teens who report high frequency of texting and driving think their teens text and drive with far less frequency than the teens themselves report they do

Here’s what we think this data means:

If you, as a parent, think you’re modeling appropriate smartphone use, your teen may misinterpret or misunderstand your smartphone use.

Now we’ll tie everything in this article together and explain what we meant when we wrote go further a moment ago.

Item 1

Although there is no official clinical diagnosis for smartphone, internet, or social media addiction, many people, including teens, display behavioral characteristics related to their smartphone that are analogous to those associated with addiction disorders.

Item 2

Distracted driving – which is a synonym for texting while driving, checking social media while driving, or browsing the internet while driving – is deadly, and teenagers/young adults engage in distracted driving more than any other age group.

Item 3

Teens who text while driving often think it’s okay because they think their parents text while driving too – even if their parents don’t.

Item 4

A teen who’s driving may not be able to resist the temptation to pick up the phone and respond to a text, a message, or a notification from a social app. A host of factors prevalent in adolescence result in their relationship with smartphones being similar to a substance use disorder or addiction, particularly the fact – supported by the statistics above – that teenager will text and drive despite the fact they know it’s both dangerous and deadly.

Which bring us to what we mean by you may need to go further when establishing family rules around texting and driving. To keep your teen safe – mostly to keep them safe from their own impulses – we recommend installing safety apps on their phone that either significantly limit smartphone function or prevent smartphone use – with some security exceptions – altogether when driving. That may seem like too much, or heavy-handed, but when we weigh the risks and benefits, the risks posed by the presence of smartphone that’s active while a car is in motion far outweigh the potential benefits.

Finally, to answer the question we pose in the introduction to this article, “Is Texting While Driving a Warning Sign or Risk Factor for Addiction?” the answer is no, we haven’t seen any evidence to that effect – but we know that risky behaviors in teens often overlap. In addition, we want parents to understand that for some teens, the urge to check their phone while driving may be so strong that it’s similar to addiction-related impulses, which means it may overpower their underdeveloped prefrontal cortex and lead to a catastrophic decision. That’s why we recommend driving safety apps – the more powerful, the better.

To find an app that may be appropriate for your family, please consult this list of helpful driving safety apps.