Distal and proximal factors of wearable users' quantified-self dependence: A cognitive-behavioral model.

Objective: While using self-tracking devices for physical health has become ubiquitous, the potential for quantified-self (QS) dependence as a detrimental outcome for mental health is under-explored. This study examined the mechanism of wearable users' QS dependence by investigating both the distal and proximal factors based on a cognitive-behavioral model. Methods: A total of 535 wearable users aged 18-35 years were surveyed in this study. The surveys included control variable questions related to age, gender, monthly income, BMI, and wearable use experience. Key variable measures included distal factor (habitual use of wearables), proximal factors (perceived external regulation, recognition, and perceived irreplaceability), and perceived QS dependence. Structural equation modeling (SEM) was used to test research hypotheses. Results: The results revealed that habitual use of wearables as a distal factor alone was negatively associated with perceived QS dependence. However, it positively influenced perceived external regulation, recognition, and perceived irreplaceability, which in turn significantly contributed to perceived QS dependence, suggesting the suppression effect of the proximal factors. Conclusions: The relationships between habitual use of wearables and QS dependence are complex. Although habitual use may seem apparently harmless, it can indirectly foster maladaptive cognitions, thereby promoting dependence. These findings underscore the potential threats of maladaptive cognitions that may arise from leveraging technology to promote physical health, thus offering guidance to technology designers for interventions.