Maartje Boer

CHAPTER 9 306 reports are important to establishwhether problematic SMU reflects addictive behavior. To that end, assessments from psychologists or addiction care professionals on whether adolescents reporting problematic SMU (i.e., six to nine symptoms on the SMD-scale) meet the criteria for a behavioral addiction are considered valuable (Billieux, Van Rooij, et al., 2017; Kardefelt-Winther et al., 2017). However, such a validation is complex, as there are no diagnostic criteria available that professionals can use as a ‘golden standard’, given the absence of a clinical recognition of problematic SMU in any diagnostic handbook. As a possible strategy, addiction care professionals could conduct diagnostic interviews based on the criteria for recognized behavioral addictions, such as gaming disorder based on the ICD-11 (World Health Organization, 2019), but then applied to SMU. According to these criteria, a gaming disorder is characterized by impaired control over gaming, prioritizing gaming over other interests and daily activities, significant distress or impairment in daily life functioning due to the gaming behavior, and continuation of gaming despite negative consequences, for a period of typically 12 months (World Health Organization, 2019). When the professional’s assessment of problematic SMU based on ICD-11 gaming criteria and an assessment based on the SMD-scale identify the same adolescents as problematic users, then this could support the suggestion that problematic SMU, asmeasured by the SMD-scale, reflects a behavioral addiction. Furthermore, it implies that the SMD-scale could be used for the purpose of screening adolescents for problematic SMU. Additional research on the nature of problematic SMU is crucial, because if more research suggests that problematic SMU should be understood as addictive behavior, then the behavior can possibly be recognized as such in a diagnostic manual as a mental disorder. Such an inclusion would facilitate professional help to problematic users of social media, because in many countries, treatments will only be reimbursed if the behavior is recognized in an official diagnostic classification system (Kuss & Billieux, 2017; Van den Brink, 2017). However, it is conceivable that the relevance of including problematic SMU as social media addiction in a diagnostic manual may change in future decades, given the rapidly changing online environments. Furthermore, diagnostic recognition of problematic SMU may raise the question whether other potential internet-related addictive behaviors, such as smartphone addiction, also require a separate diagnostic category. It