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《精神疾病诊断与统计手册》第五版互联网使用障碍标准的预测能力:CHAID决策树分析

Predictive power of the DSM-5 criteria for internet use disorder: A CHAID decision-tree analysis.

作者信息

Bottel Laura, Brand Matthias, Dieris-Hirche Jan, Pape Magdalena, Herpertz Stephan, Te Wildt Bert Theodor

机构信息

LWL-University Hospital, Department of Psychosomatic Medicine and Psychotherapy, Ruhr University Bochum, Bochum, Germany.

General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR), University of Duisburg-Essen, Duisburg, Germany.

出版信息

Front Psychol. 2023 Feb 22;14:1129769. doi: 10.3389/fpsyg.2023.1129769. eCollection 2023.

Abstract

INTRODUCTION

Although the majority of internet users enjoy the internet as a recreational activity, some individuals report problematic internet use behaviors causing negative psychosocial consequences. Therefore, it is important to have precise and valid diagnostic criteria to ensure suitable treatment for those affected and avoid over-pathologization.

METHODS

The aim of the present study was to determine which of the nine DSM-5 criteria of internet gaming disorder (IGD) are crucial in distinguish pathological from non-pathological internet use based on the questionnaire-based response behavior of the participants by applying the Chi-squared automatic interaction detection (CHAID) decision tree analysis. Under consideration of the nine DSM-5 criteria for IGD and according to the short-form scale to assess Internet Gaming Disorder (IGDS-SF9) the DSM-5 criteria were formulated as questions and applied to the broader concept of Internet Use Disorder (IUD). The nine questions were answered on a 5-point Likert scale from "never" to "very often." In accordance with the IGDS-SF9 participants were assigned to IUD-5plus if at least 5 of the 9 criteria were answered with "very often." The study was conducted in Germany ( = 37,008; : 32 years,  = 13.18, 73.8% male).

RESULTS

Although "loss of control," "continued overuse" and "mood regulation" were the most endorsed criteria, the analysis indicated that the criterion "jeopardizing" was found as the best predictor for IUD-5plus, followed by "loss of interest" and "continued overuse." Overall 64.9% of all participants who were in the IUD-5plus, could been identified by the fulfillment of the three criteria mentioned above.

DISCUSSION

The results found support for adjustment of the DSM-5 criteria of IGD in accordance to ICD-11. If the predictive power of the three criteria can be replicated in future representative studies, such a decision tree can be used as guidance for diagnostics to capture the particularly relevant criteria.

摘要

引言

尽管大多数互联网用户将上网作为一种娱乐活动,但一些人报告存在有问题的互联网使用行为,会导致负面的心理社会后果。因此,拥有精确有效的诊断标准对于确保为受影响者提供适当治疗并避免过度病理化至关重要。

方法

本研究的目的是通过应用卡方自动交互检测(CHAID)决策树分析,根据参与者基于问卷的反应行为,确定《精神疾病诊断与统计手册》第五版(DSM-5)中九项网络游戏障碍(IGD)标准中的哪些标准对于区分病理性与非病理性互联网使用至关重要。考虑到DSM-5中IGD的九项标准,并根据评估网络游戏障碍的简版量表(IGDS-SF9),将DSM-5标准表述为问题,并应用于更广泛的互联网使用障碍(IUD)概念。这九个问题采用从“从不”到“非常频繁”的5点李克特量表进行回答。根据IGDS-SF9,如果9项标准中至少有5项被回答为“非常频繁”,则参与者被归类为IUD-5plus。该研究在德国进行(n = 37,008;平均年龄:32岁,标准差 = 13.18,73.8%为男性)。

结果

尽管“失控”“持续过度使用”和“情绪调节”是被认可最多的标准,但分析表明,“危及”标准被发现是IUD-5plus的最佳预测指标,其次是“兴趣丧失”和“持续过度使用”。总体而言,所有IUD-5plus参与者中有64.9%可通过满足上述三项标准来识别。

讨论

研究结果支持根据《国际疾病分类》第11版(ICD-11)对DSM-5中IGD标准进行调整。如果这三项标准预测能力能够在未来的代表性研究中得到重复验证,那么这样的决策树可作为诊断指南,以捕捉特别相关的标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e47/9994355/cad8e895208f/fpsyg-14-1129769-g001.jpg

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