ICD-11-Based Assessment of Social Media Use Disorder in Adolescents: Development and Validation of the Social Media Use Disorder Scale for Adolescents

Abstract

Background: A problematic social media use (PSMU) in adolescents is a rising phenomenon often associated with higher perception of psychological stress and comorbid psychiatric disorders like depression. Since the ICD-11 introduced the very first internet-use related disorders, criteria for gaming (and online gambling) disorder can now be transferred to assess social media use disorder (SMUD). Therefore, the development and validation of a self-rating screening instrument for SMUD is of value to researchers and clinicians.Method: The previously validated ICD-11-based Gaming Disorder Scale for Adolescents (GADIS-A) was adapted to measure SMUD (Social Media Use Disorder Scale for Adolescents, SOMEDIS-A). A representative sample of 931 adolescents aged 10 to 17 years and a respective parent participated in an online study. Item structure was evaluated by factorial analyses. Validated DSM-5-based instruments to assess PSMU by self- and parental ratings (SMDS, SMDS-P), adolescent depressive symptoms (PHQ-9), and stress perception (PSS-10) as well as single items on time spent with social media (SM, frequency and duration) were applied to assess criterion validity. Discrimination between pathological and non-pathological users was examined based on ROC analyses retrieved cut-off values and the results of a latent profile analysis.Results: The new scale is best described by two factors reflecting cognitive-behavioral symptoms and associated negative consequences. The internal consistency was good to excellent. The SOMEDIS-A-sum score was positively correlated with PSMU, depression, and stress scores as well as the time spent with SM in a moderately to highly significant manner. Thus, good to excellent criterion validity is suggested.Conclusions: SOMEDIS-A is the first successfully validated instrument to assess SMUD in adolescents based on the ICD-11 criteria of GD. Thus, it can support early detection in order to prevent symptom aggravation, chronification, and secondary comorbidities. It can contribute to the development of a standardized conceptualization and its two-factorial structure offers promising new insights into the evaluation of SM usage patterns. Further examination including clinical validation is desirable.

Examining the Interplay of Smartphone Use Disorder, Mental Health, and Physical Symptoms

“…In the context of computer and videogames, the World Health Organization (WHO) uses the term Gaming Disorder to describe such problematic forms of use. Consequently, scientists have started to use the terms disorde r or disordered use also in relation to other forms of addictive media technology use, like, for example, social media (use) disorder [e.g., ( 19 , 20 )]. Following Sha et al ( 21 ) and others [e.g., ( 22 , 23 )] we will use the term Smartphone Use Disorder (SmUD) as a synonym for uncontrolled, addictive smartphone use in the following.…”

The ICD-11 For the Twenty-First Century: The First View from The Organizational, Legal, Clinical and Pharmacological Aspects

“…In the ICD-11, gaming disorders are included for the assessment of disorders associated with social media use. Cognitive behavioral symptoms of gambling disorders and their negative consequences support the assumption that gaming addiction on social networks deserves its own conceptualization in the context of the ICD-11 behavioral addictions and may contribute to the development of standardized conceptualization in the future [38].…”

Applying ICD-11 criteria of Gaming Disorder to identify problematic video streaming in adolescents: Conceptualization of a new clinical phenomenon

“…Problematic VS was assessed by the Streaming Disorder Scale for Adolescents (STREDIS-A) which was developed by clinical and scientific experts in the field of behavioral addictions in adolescence. It was adapted from the ICD-11-based Gaming Disorder Scale for Adolescents (GADIS-A; Paschke, Austermann, & Thomasius, 2020 ; WHO, 2018 ) and already successfully applied to the problematic use of social media (Social Media Use Disorder Scale for Adolescents [SOMEDIS-A], Paschke, Austermann, & Thomasius, 2021b ). Adolescents were asked to indicate their agreement with nine statements by choosing one out of five (Likert-scale) response options when thinking of the past 12 months ( strongly disagree [0]— strongly agree [4]).…”

“…Participants reported depressive symptoms on the 9-item Patient Health Questionnaire (PHQ-9) adapted for adolescents ( Kroenke, Spitzer, & Williams, 2001 ; Paschke et al., 2021b ) and anxiety symptoms by the 2-item version of the Generalized Anxiety Disorder Scale (GAD-2) with higher scores indicating more symptoms ( Kroenke, Spitzer, Williams, Monahan, & Löwe, 2007 ; Parodi et al., 2022 ). Additionally, insomnia symptoms were measured with the 7-item Insomnia Severity Index (ISI; Bastien, Vallières, & Morin, 2001 ; Gerber et al., 2016 ) and loneliness with a 6-item version of the Revised UCLA Loneliness Scale (R-ULS; Hudiyana et al, 2021 ; Neto, 1992 ; Russell, Peplau, & Cutrona, 1980 ).…”