Validation of the DSM-5 internet gaming disorder framework for clinical diagnosis of problematic social media usage.

Aims: Problematic social media usage (PUSM) has become a growing public health issue, with adolescents being particularly vulnerable. The absence of a standardized diagnostic tool has hindered consistent clinical identification and research advancement. To address this gap, the present study systematically evaluated the applicability of the DSM-5 Internet gaming disorder (IGD) criteria for diagnosing PUSM. Methods: A total of 405 participants were recruited and divided into five groups: PUSM, gaming disorder (GD), regular social media users (RSMU), regular gamers (RG), and healthy controls (HC). In this study, patients were evaluated using both ICD-11 and DSM-5. The ICD-11 criteria served as an external criterion, providing a benchmark for the validity testing of the DSM-5 framework. Results: The DSM-5 IGD criteria demonstrated excellent diagnostic accuracy (>80%) for both PUSM and GD, except "deception". The ICD-11 and DSM-5 criteria exhibited high consistency, though the ICD-11 criteria adopted a stricter diagnostic threshold. No significant differences were observed between the PUSM and GD groups in terms of symptom profiles, functional impairment, or clinical severity. Discussion and conclusions: This study provides empirical support for adopting the DSM-5 IGD diagnostic criteria as a standardized clinical tool for assessing PUSM. However, the "deception" criterion requires further validation due to its weak diagnostic performance. The findings further confirm the conceptual and symptomatic homogeneity between PUSM and IGD, supporting their classification within a unified behavioral addiction framework.