EXAMPLE OF NOMOPHOBIA

QUESTIONNAIRE
by Macasyraf
Purpose of Study: The purpose of this study is to examine the potential of students that might
have suffered with Nomophobia. Nomophobia or No Mobile Phone Phobia is the irrational
fear of being without mobile phone or unable to use it for some reason.

Instructions: Please put a tick ✓ in the box next to the answer of your choice or write in
the space provided. Do NOT write your name on this questionnaire. Your responses will
be anonymous and will never be linked to you personally. Your participation is entirely
voluntary. If there are items, you do not feel comfortable answering please skip them.
Thank you for your cooperation.

SECTION A: DEMOGRAPHICS

Please tick ✓ the most appropriate response and fill the blank required.

1. Age: _________________________________________________________________

2. Gender:

Male [ ] Female [ ]

3. Semester: ____________________________________________________________

1 [ ] 2 [ ] 3 [ ] 4 [ ] 5 [ ] 6 [ ] 7 [ ] 8 [ ] Others: ______________

4. Major: _______________________________________________________________

5. College:

COLGIS [ ] CAS [ ] COB [ ]

SECTION B: SMARTPHONE USE

Please tick ✓ the most appropriate response and fill the blank required.

6. For how long have you been using a smartphone?

Less than a year [ ]

1 year to less than 2 years [ ]
2 years to less than 3 years [ ]
3 years to less than 4 years [ ]
4 years to less than 5 years [ ]
5 years or more [ ]

7. Approximately how much times per day you think you spend using your smartphone?

__________________ times.

8. How often do you think you usually check your smartphone?

Every 5 minutes [ ]
Every 10 minutes [ ]
Every 30 minutes [ ]
Every hour [ ]
Others: _______________________________________________________________

9. For which of the following purposes do you usually use your smartphone? Select ALL
that apply.

Checking social media [ ]

Listening to music [ ]
Gaming [ ]
Killing time [ ]
Others: _______________________________________________________________
SECTION C: NOMOPHOBIA QUESTIONNAIRE

Please tick ✓ to indicate how much you rarely or frequently with each statement in
relation to your smartphone use.

Scale: 1. Rarely | 2. Sometimes | 3. Often | 4. Rarely Often

Frequently 1 2 3 4
I often think about my smartphone
10.
when I am not using it.
I often use my smartphone for no
11.
particular reason.
Arguments have arisen with others
12.
because of my smartphone use.
I interrupt whatever else I am doing
13. when I am contacted on my
smartphone.
I feel connected to others when using
14.
my smartphone.
The thought of being without my
15.
smartphone makes me feel distressed.
I have been unable to reduce my
16.
smartphone use.
If I could not check my smartphone for a
17.
while, I would feel a desire to check it.
I would feel awkward because I could
18.
not stay up to date with social media.
I have gone to bed late or slept less
19.
because I was using my phone.
As soon as I get up in the morning, first
20.
thing I do is check my smartphone.