Addictive Behaviors 101 (2020) 105969

Contents lists available at ScienceDirect

Addictive Behaviors
journal homepage: www.elsevier.com/locate/addictbeh

Measurement invariance across young adults from Hong Kong and Taiwan T
among three internet-related addiction scales: Bergen Social Media Addiction
Scale (BSMAS), Smartphone Application-Based Addiction Scale (SABAS), and
Internet Gaming Disorder Scale-Short Form (IGDS-SF9) (Study Part A)
Hildie Leunga, Amir H. Pakpourb,c, Carol Strongd, Yi-Ching Line, Meng-Che Tsaif,
Mark D. Griffithsg, Chung-Ying Linh, , I-Hua Cheni
⁎

a
Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
b
Social Determinants of Health Research Center, Department of Nursing, Qazvin University of Medical Sciences, Shahid Bahounar BLV, Qazvin 3419759811, Iran
c
School of Health and Welfare, Jönköping University, Jönköping, Sweden
d
Department of Public Health, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
e
Department of Early Childhood and Family Education, National Taipei University of Education, Taipei, Taiwan
f
Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
g
International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
h
Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
i
Chinese Academy of Education Big Data, Qufu Normal University, Shandong, China

HIGHLIGHTS

• Chinese Bergen Social Media Addiction Scale has unidimensional structure.

• Chinese Smartphone Application-Based Addiction Scale has unidimensional structure.
• Chinese Internet Gaming Disorder Scale-Short Form has unidimensional structure.

ARTICLE INFO ABSTRACT

Keywords: Internet addiction has been found to be prevalent worldwide, including Asian countries, and related to several
Internet gaming disorder negative outcomes and other behavioral addictions. The Bergen Social Media Addiction Scale (BSMAS),
Smartphone addiction Smartphone Application-Based Addiction Scale (SABAS), and nine-item Internet Gaming Disorder Scale-Short
Measurement invariance Form (IGDS-SF9) have been extensively used to assess internet-related addictions. However, the three afore-
Chinese
mentioned instruments have rarely been used in Asian countries. The aim of the present study was to investigate
Social media addiction
whether the BSMAS, SABAS, and IGDS-SF9 were appropriate for use in heterogeneous subsamples from Hong
Kong and Taiwan. University students from Hong Kong (n = 306) and Taiwan (n = 336) were recruited via an
online survey. Multigroup confirmatory factor analysis (MGCFA) was used to assess measurement invariance of
the BSMAS, SABAS, and IGDS-SF9 across the two subcultures. The original unidimensional structures of BSMAS,
SABAS and IGDS-SF9 were confirmed through confirmatory factorial analysis in both subcultures. The MGCFA
results showed that the unidimensional structures of the BSMAS and IGDS-SF9 were invariant across the two
Chinese cultural areas (Hong Kong and Taiwan). However, the measurement invariance of the SABAS was es-
tablished after some model modifications. In conclusion, the present study found that the Chinese BSMAS,
SABAS, and IGDS-SF9 were all adequate instruments to validly assess internet-related addictions among uni-
versity students. The three brief instruments used for assessing addictions to social media, smartphone appli-
cations, and online gaming are valid and psychometrically robust across two Chinese subcultures and can be
used by healthcare professionals in these regions.

⁎
Corresponding author.
E-mail address: [email protected] (C.-Y. Lin).

https://doi.org/10.1016/j.addbeh.2019.04.027
Received 5 October 2018; Received in revised form 24 April 2019; Accepted 25 April 2019
Available online 27 April 2019
0306-4603/ © 2019 Elsevier Ltd. All rights reserved.
H. Leung, et al. Addictive Behaviors 101 (2020) 105969

1. Introduction qualities were negatively associated with the internet addiction. In

Taiwan, Lin, Wu, You, Hu, and Yen (2018) reported that nearly one-
Due to the rapid growth of technology, the use of the internet has fifth of high school students experienced internet addiction. They also
become widespread in many individual's daily routines. Research by the reported that the internet addiction was correlated with high im-
Pew Research Center (2016) indicated that 54% of individuals (median pulsivity, depressive symptoms, and low subjective wellbeing.
percentage) across 21 emerging and developing countries (e.g., Ma- Given that Hong Kong and Taiwan share a similar culture and
laysia, mainland China) had used the internet. Among 11 countries with written language system (Chang, Lin, Gronholm, & Wu, 2018), studies
advanced economies, this was even higher at 87% (e.g., United States, on Chinese culture usually compare the similarities and differences
Canada) in 2015 (Pew Research Center, 2016). In addition, given the between these two areas (e.g., Hsu & Wang, 2018; Ip, Liang, Wu, Law, &
development of Wi-Fi and the wide variety of smartphone applications Liu, 2018). In order to make meaningful comparisons, there is a need to
(‘apps’), increasingly more people own a smartphone with an estimated test the linguistic equivalence among instruments across those living in
60% to 95% of young adults having a smartphone across developing Hong Kong and Taiwan. Unfortunately, the literature gap shows that
and developed countries (Yang, Chen, Huang, Lin, & Chang, 2017). the lack of such instruments that can be simultaneously used in both
Among those who own a smartphone, the Pew Research Center (2016) areas. Additionally, to the best of the present authors' knowledge, no
reported nearly three-quarters of adult users accessed the internet at brief instruments have been developed to assess social media addiction
least once per day and 76% of them accessed social networking sites or smartphone addiction in these two areas. Although the Smartphone
(e.g., Facebook, Twitter) whenever they surfed online. In addition to Addiction Inventory (SPAI) was developed in Taiwan (Lin et al., 2014),
social media use, another common internet activity is online gaming it contains a relatively large number of items (n = 26). In terms of an
(Kuss & Griffiths, 2012; Kuss, Griffiths, Karila, & Billieux, 2014). instrument to assess IGD, Sigerson, Li, Cheung, Luk, and Cheng (2017)
Research has consistently shown that various online activities such used the IGD criteria from DSM-5 to develop a Chinese Internet Gaming
as online gaming and social media use may be potentially addictive to a Disorder Scale (C-IGDS), which comprised nine items. However, the C-
small minority of individuals particularly adolescents and emerging IGDS adopts a dichotomous rating scale across the nine items, which
adults (Cheng & Li, 2014; Kuss et al., 2014; Kuss & Griffiths, 2012; arguably restricts the score distribution. More specifically, the score
Ryan, Chester, Reece, & Xenos, 2014). The latest (fifth) version of the range of the C-IGDS is 0–9 and is hard to achieve a normal distribution
Diagnostic and Statistical Manual of Mental Disorders (DSM-5) identified for statistical testing. As a result, there is a need for an ultra-brief in-
the potential negative effects of problematic online gaming on the strument (i.e., < 10 items) with a more widespread rating option (e.g.,
wellbeing of an individual. Consequently, the DSM-5 has recognized 5-point Likert-type response) for researchers to efficiently and effec-
Internet Gaming Disorder (IGD) as a tentative disorder (American tively assess social media addiction, smartphone addiction, and IGD.
Psychiatric Association, 2013). Similarly, the World Health Organiza- However, healthcare providers may have alternative options to assess
tion (Van den Brink, 2017) has also proposed to include online and these different types of addiction related to internet but can utilize such
offline gaming disorders in the eleventh revision of the International instruments as an addition to their other assessment criteria.
Statistical Classification of Diseases and Related Health Problems (ICD-11) Although several measures have been developed to assess internet
although the formal decision of inclusion is still pending at the time of addiction, including the addictive use of social media, these measures
writing. In addition to IGD, social media addiction appears to be an- may not be comparable in terms of the theoretical basis and the char-
other growing issue (e.g., Kuss & Griffiths, 2017; Pantic, 2014; Ryan acteristics of the scales. Consequently, there is still a lack of general
et al., 2014). One of the main contributory factors in the growth of consensus on definition of generalized internet addiction and several
internet-related addictions is the increasing ubiquity of smartphone use. grounding theoretical frameworks have been used in developing in-
Smartphones now provide individuals with a convenient and mobile ternet addiction scales (Beard, 2005; Starcevic & Aboujaoude, 2017;
way to access many different types of content that can be potentially Weinstein & Lejoyeux, 2010). (Beard, 2005; Starcevic & Aboujaoude,
addictive to a small minority (e.g., gambling, gaming, shopping, social 2017; Weinstein & Lejoyeux, 2010). In addition, many of these instru-
media; Billieux, Maurage, Lopez-Fernandez, Kuss, & Griffiths, 2015; ments lack rigorous and systematic psychometric investigations
Kuss & Griffiths, 2017). (Laconi, Rodgers, & Chabrol, 2014). Because of heterogeneity of these
However, in the literature concerning internet addiction and related measures across studies, a literature review was undertaken to identify
topics, there is no consensus on the use of terminology to describe potential important measures to assess internet addiction.
problematic internet use because it has variously been described as After reviewing the contemporary literature, the research team
internet dependence, internet addiction, pathological internet use, proposed to translate and validate three psychometric scales: Bergen
problematic internet use, internet use disorder, and internet addiction Social Media Addiction Scale (BSMAS; Andreassen et al., 2016);
disorder (among others) (Kuss et al., 2014). There are also debates Smartphone Application-Based Addiction Scale (SABAS; Csibi, Griffiths,
about whether problems with specific internet applications (e.g., social Cook, Demetrovics, & Szabo, 2018); and the nine-item Internet Gaming
media use, gaming) or problematic behavior via other types of Wi-Fi Disorder Scale-Short Form (IGDS-SF9; Pontes & Griffiths, 2015). The
enabled hardware (e.g., ‘smartphone addiction’) should be classed as main reasons of using these instruments include their brevity (IGDS-SF9
problematic behaviors in their own right or subsumed within the um- has nine items; BSMAS and SABAS both have six items) and robust
brella term of ‘internet addiction’ (Brand, Young, Laier, Wölfling, & psychometric properties based on previous studies (see ‘Measures’
Potenza, 2016; Pontes, Szabo, & Griffiths, 2015). Despite these different section below for detailed information). More importantly, the three
terminologies used, internet-related disorders have received growing instruments assess different aspects of internet addiction. The aims of
research interest and require further investigation. Indeed, many stu- the present study were to (i) investigate the factorial structures and
dies have explored internet-related addiction from different aspects, basic psychometric properties of the three instruments; and (ii) examine
such as epidemiological studies, comorbidity studies, neuroimaging the measurement invariance of the three instruments across university
studies, and intervention and treatment studies (e.g., Kuss et al., 2014; students in Hong Kong and Taiwan.
Kuss, Pontes, & Griffiths, 2018; Shek & Leung, 2013; Shek & Yu, 2016).
The phenomenon of problematic internet use is similar between two
westernized Asian areas, which share similar traditional Chinese cul- 2. Methods
tures (i.e., Hong Kong and Taiwan, where the present study was carried
out). Shek and Yu (2016) reported that the prevalence of internet ad- The study was approved by the ethics committee of the Hong Kong
diction ranges between 17% and 26% among Hong Kong adolescents. Polytechnic University before the commencement.
In their longitudinal study, general positive youth development

2
H. Leung, et al. Addictive Behaviors 101 (2020) 105969

2.1. Translation procedure being at risk of developing a social media addiction. More recently, a
cutoff score of 19 (out of 30) for problematic use of social media on the
The three instruments (i.e., BSMAS, SABAS, and IGDS-SF9) followed BSMAS was proposed by Bányai et al. (2017) following a large na-
a standardized back-translation process (Beaton, Bombardier, tionally representative study of nearly 6000 Hungarian adolescents.
Guillemin, & Ferraz, 2000) with consideration in Chinese systems in The psychometric properties of the BSMAS have been supported in
written language (Chang et al., 2018; Wu, Chang, Chen, Wang, & Lin, different language versions, including English (Andreassen et al., 2016),
2015). Detailed information is provided in Appendix A. Italian (Monacis, De Palo, Griffiths, & Sinatra, 2017), Persian (Lin,
Broström, Nilsen, Griffiths, & Pakpour, 2017), and Portuguese (Pontes,
2.2. Participants and procedure Andreassen, & Griffiths, 2016).
The Smartphone Application-Based Addiction Scale (SABAS) de-
All the scales (BSMAS, SABAS, and IGDS-SF9), and questions con- veloped by Csibi et al. (2018) comprises six items assessing the single
cerning demographic information and informed consent were in- construct of smartphone use addiction. The six items are also based on
corporated in an online questionnaire survey via Google Forms. The the six core criteria of the addiction components model (Griffiths,
details of the study's purpose and requirements were provided on the 2005). Using a six-point Likert type scale ranging between 1 (strongly
first page of the online survey, and only those who provided their in- disagree) and 6 (strongly agree), a higher score in the SABAS indicates a
formed consent to participate could continue answering the survey greater likelihood of being at risk of developing an addiction to
questions. The online survey was accessed via a hyperlink and a QR smartphone use. The psychometric properties of the SABAS have been
code for students to log onto Google Forms. Several research assistants supported in different language versions including English (Csibi et al.,
disseminated the survey link and QR code in the university lectures 2018) and Hungarian (Csibi, Demetrovics, & Szabo, 2016).
with the permission of the teaching faculties. The inclusion criteria for The Internet Gaming Disorder Scale-Short Form (IGDS-SF9) devel-
being a participant were (i) being aged 18 years or older; (2) having the oped by Pontes and Griffiths (2015) comprises the nine IGD criteria
ability to understand written Chinese in traditional characters; (3) described in the latest (fifth) edition of the Diagnostic and Statistical
possessing a smartphone; and (4) having access to the internet. Those Manual of Mental Disorders (DSM-5) (American Psychiatric Association,
with a diagnosed mental health problem (e.g., mood disorders) were 2013). Using a five-point Likert type scale ranging between 1 (never)
excluded. Individuals with a diagnosed mental health problem were and 5 (very often), a higher score in the IGDS-SF9 indicates a greater
excluded to ensure the homogeneity of our studied population. The likelihood of being at risk of developing IGD. The IGDS-SF9 has been
prevalence of having a diagnosed mental health problem is relatively validated with promising psychometric properties in several studies and
low among university students. Therefore, such students could be po- different languages, including English (Pontes & Griffiths, 2015; Pontes,
tential outlier in the sample recruited. Stavropoulos, & Griffiths, 2017), Portuguese (Pontes & Griffiths, 2016),
The inclusion and exclusion criteria were assessed by the re- Italian (Monacis, Palo, Griffiths, & Sinatra, 2016), Persian (Wu et al.,
spondents' self-reports from the demographic information in the survey. 2017), Polish (Schivinski, Brzozowska-Woś, Buchanan, Griffiths, &
In order to ensure that no respondents completed the survey more than Pontes, 2018), Albanian (de Palo et al., 2018), and Turkish (Arıcak,
once, each participant was asked to provide their cellphone number and Dinç, Yay, & Griffiths, 2018; Evren et al., 2018).
an email account. Although the participants were requested to provide
personal information in the present study, anonymity and con- 2.4. Data analysis
fidentiality was ensured through the following methods. First, all par-
ticipants did not need not to provide their real names in the study. Because the three instruments adopt a Likert-type scale, analyses
Therefore, the research team did not know who the cellphone number were used that tackled categorical data and did not assume normal
or email account was of any participant. Second, only the research team distribution. Therefore, the ordinal α and confirmatory factor analysis
had the access to retrieve the data. Third, all personal information will (CFA) with the diagonally weighted least square (DWLS) estimator was
be destroyed after the study completed. Following this process, a total used. Item properties of the three scales were examined using factor
of 308 students from Hong Kong and 337 students from Taiwan agreed loadings derived from CFA and the corrected item-total correlation. In
to participate. Two Hong Kong students and one Taiwanese student addition, psychometric properties in the scale level were examined
were excluded due to having diagnosed mental health problems. This using ordinal α and CFA. Ordinal α was used to tackle the ordinal
left 306 Hong Kong students and 336 Taiwanese students remaining in nature in the Likert-type scales used in the three scales. In terms of the
the present study for further analysis. CFA, the Likert-type response options used in the three scales were
After collecting the baseline data, all of the 306 Hong Kong students tackled by the DWLS estimator (Lin, Updegraff, & Pakpour, 2016).
and 336 Taiwanese students were contacted again using the cellphone Given that the three scales assess different types of addictive behaviors
number or email account they left to complete a follow-up. In the in a one-factor structure, six first-order CFAs in a one-factor structure
present study, only baseline data were used, while baseline and follow- were conducted (three CFAs using the Hong Kong sample; three using
up data were used in another study with detailed information described the Taiwan sample). Also, the IGDS-SF9 structure was tested using the
elsewhere (Chen et al., 2019). Additionally, from the response of time multiple indicators multiple causes (MIMIC) model because gamers/
on gaming, 458 were classified as non-gamers (i.e., they did not play non-gamers were considered to be a potential confounder in its factorial
online game regularly) and 184 were classified as gamers (i.e., they structure. Therefore, the gamers/non-gamers were treated as a con-
played online game regularly; at least one hour per week). trolled variable in the MIMIC model for IGDS-SF9. Fit indices, including
a nonsignificant χ2 test, a comparative fit index (CFI) > 0.9, a Tucker-
2.3. Measures Lewis index (TLI) > 0.9, a root mean square error of approximation
(RMSEA) < 0.08, a standardized root mean square residual
The Bergen Social Media Addiction Scale (BSMAS) developed by (SRMR) < 0.08, and a weighted root mean square residual
Andreassen et al. (2016) comprises six items based on the six core (WRMR) < 1 (Cook, Kallen, & Amtmann, 2009; Wu et al., 2015), were
components (salience, mood, modification, tolerance, withdrawal adopted to examine whether the one-factor structure was supported in a
conflict and relapse) proposed by Griffiths (2000, 2005) to assess social specific scale for Hong Kong or Taiwan participants.
media addiction. More specifically, the six items examine the experi- Measurement invariance across Hong Kong and Taiwan participants
ence of using social media over the past year and are responded to using was then examined for those scale scores which had satisfactory fit
a five-point Likert type scale ranging between 1 (very rarely) and 5 (very indices in the CFAs for both Hong Kong and Taiwan participants. Three
often). A higher score in the BSMAS indicates a greater likelihood of nested models in the multigroup CFA (MGCFA) were constructed and

3
H. Leung, et al. Addictive Behaviors 101 (2020) 105969

compared to determine whether measurement invariance was sup- unmatched living expenses and currency rates.
ported: a configural model, a model with factor loadings constrained Table 2 shows the satisfactory item properties of the BSMAS,
equal across Hong Kong and Taiwan participants, and a model with SABAS, and IGDS-SF9 for Hong Kong and Taiwan participants, re-
factor loadings and item thresholds constrained equal across Hong Kong spectively. In terms of the scale properties, ordinal α was satisfactory in
and Taiwan participants (Jafari, Nozari, Ahrari, & Bagheri, 2017; van all three scales. For BSMAS, α = 0.85 for Hong Kong participants; 0.82
de Schoot, Lugtig, & Hox, 2012). Measurement invariance is supported for Taiwan participants. For SABAS, α = 0.78 for Hong Kong partici-
if the comparison between every two models (i.e., configural model vs. pants; 0.79 for Taiwan participants. For IGDS-SF9, α = 0.93 for Hong
model with factor loadings constrained equal and model with factor Kong participants; 0.94 for Taiwan participants. Excellent fit indices
loadings constrained equal vs. model with factor loadings and item were also observed for the three scales (Table 3), except for a slightly
thresholds constrained equal) show the following indices: ∆CFI > - high WRMR (1.131) for BSMAS among Taiwan participants.
0.01 (Lin et al., 2013), ∆RMSEA < 0.02 (Lin et al., 2012), and After ensuring that the factorial structures were supported for the
∆SRMR < 0.03 (for invariant loadings) or 0.01 (for invariant thresh- three scales separately in Hong Kong and Taiwan participants, the
olds) (Chen, 2007). After ensuring the measurement invariance across MGCFAs were applied to detect whether Hong Kong and Taiwan par-
Hong Kong and Taiwan participants, Pearson correlation coefficients ticipants interpret the scales differently. Both BSMAS and IGDS-SF9 had
were used to examine the associations between time spent on social their measurement invariance supported at factor loadings (except for a
media, time spent on smartphones, time on gaming, and scores on the slightly high ∆RMSEA of 0.024 in the IGDS-SF9) and item thresholds
BSMAS, SABAS, and IGDS-SF9. Moreover, given that both non-gamers without relaxing any parameters. However, the SABAS had its mea-
and gamers were recruited (i.e., whether the participants played online surement invariance supported after relaxing one factor loading (item
games regularly, and where a gamer was defined as playing an online S1: My smartphone is the most important thing in my life) and two item
game at least one hour per week), the BSMAS, SABAS, and IGDS-SF9 thresholds (items S1 and S3: Preoccupying myself with my smartphone is a
was compared between gamers and non-gamers. Independent t-tests way of changing my mood) (Table 4). Also, Table 5 shows the correlation
with Cohen's d were used for the comparisons. All the analyses were matrix among time spent on social media, time spent on smartphones,
performed using R software. More specifically, ordinal α and corrected time spent on gaming, and scores on the BSMAS, SABAS, and IGDS-SF9.
item-total correlations were computed using the Psych package More specifically, the correlation matrix was conducted for the entire
(https://cran.r-project.org/web/packages/psych/psych.pdf); CFA and sample, including gamer and non-gamer subgroups. Additionally, the
MGCFA using the lavaan package (http://lavaan.ugent.be/). addictive behaviors were significantly different between gamers and
non-gamers. BSMAS scores were 2.31 ± 0.74 for gamers and
3. Results 2.57 ± 0.69 for gamers (Cohen's d = 0.35; p < 0.001); SABAS scores
were 3.63 ± 0.96 for gamers and 3.43 ± 0.19 for non-gamers (Co-
The Hong Kong participants were significantly older than the hen's d = 0.21; p = 0.014); and IGDS-SF9 scores were 2.41 ± 0.67 for
Taiwan participants (24.08 years ± 5.06 vs. 20.51 years ± 1.22; gamers and 1.66 ± 0.62 for non-gamers (Cohen's d = 1.17;
p < 0.001), and the Hong Kong participants had significantly fewer p < 0.001).
males than the Taiwan participants (n = 99 [32.4%] vs. 167 [49.7%];
p < 0.001). No significant differences were found between Hong Kong 4. Discussion
and Taiwan participants in the percentage of being a current smoker,
the average hours per week spent on smartphone, and the average To the best of the present authors' knowledge, this is the first study
hours per week spent on social media. However, Hong Kong partici- that examines the measurement invariance across two Chinese cultural
pants engaged less in the gaming (0.99 ± 1.70 h/week) compared with areas (Hong Kong and Taiwan) in three internet addiction-related
the Taiwan participants (1.32 ± 2.06; p = 0.03), although no sig- scales. In addition, the measurement invariance of the English IGDS-SF9
nificant differences were found when the participants were separated has only recently been studied (de Palo et al., 2018;Pontes et al., 2017;
into gamer and non-gamer subgroups. Also, approximately 60% of the Stavropoulos et al., 2018), and no measurement invariance studies have
Hong Kong participants had a monthly income < 10,000 Hong Kong ever been conducted for either the BSMAS or SABAS. In the study
dollars whereas almost all Taiwan participants had a monthly in- conducted by Pontes et al. (2017), the unidimensional structure of the
come < 10,000 New Taiwanese dollars (Table 1), where the exchange English IGDS-SF9 was confirmed among gamers in the United States,
rate between Hong Kong and New Taiwanese dollars is about 1:4. United Kingdom, and India. However, the measurement invariance was
However, the monthly incomes between Hong Kong and Taiwan par- only partially supported: loadings in Items 1, 3, 7, 8, and 9; intercepts in
ticipants were not compared using inferential statistics due to Items 2, 3, 4, 8, and 9 were relaxed to achieve the satisfactory indices.

Table 1
Participant characteristics of samples in Hong Kong and Taiwan and differences between the samples.
Hong Kong (n = 306) Taiwan (n = 336) t or χ2 (p-value) Effect sizea

Age (years); M ± SD 24.08 ± 5.06 20.51 ± 1.22 11.50 (< 0.001) 0.97
Gender (male); n (%) 99 (32.4) 167 (49.7) 19.87 (< 0.001) 0.18
Current smoker (no); n (%) 300 (98.0) 332 (98.8) 0.22 (0.64) 0.03
Time on social media (hours/week); M ± SD 3.11 ± 3.38 3.26 ± 2.47 0.65 (0.52) 0.05
Time on smartphone (hours/week); M ± SD 5.29 ± 3.79 5.07 ± 2.75 0.84 (0.40) 0.07
Time on gaming (hours/week); M ± SD 0.99 ± 1.70 1.32 ± 2.06 2.21 (0.03) 0.17
Time on gaming for gamersb (hours/week); M ± SD 0.34 ± 0.43 (n = 232) 0.36 ± 0.44 (n = 226) 0.31 (0.76) 0.06
Time on gaming for non-gamersb (hours/week); M ± SD 3.03 ± 2.45 (n = 74) 3.30 ± 2.59 (n = 110) 0.73 (0.47) 0.22
Monthly income (< 10,000 dollarsc); n (%) 175 (57.2) 308 (91.7) –d –d

a
Cohen's d (0.2 = small; 0.5 = medium; 0.8 = large) is used to assess the effect sizes of Age, Time on smartphone, Time on social media, and Time on gaming;
Cramer's V (0.1 = small; 0.3 = medium; 0.5 = large) is used to assess the effect sizes of Gender and Current smoker.
b
Whether the participants played online games regularly, and a gamer was defined as playing an online game at least one hour per week.
c
Hong Kong participants reported in Hong Kong Dollars (HKD) with 1 USD ≈ 7.8 HKD; Taiwan participants reported in New Taiwanese Dollars (NTW) with 1
USD ≈ 30 NTD.
d
Monthly income was not compared between Hong Kong and Taiwan participants because the unmatched living expenses and the unmatched currency rates.

4
 H. Leung, et al.

Table 2
Item properties in the three scales across Hong Kong and Taiwan participants.
Hong Kong Taiwan

M (SD) Loading Item-total correlation M (SD) Loading Item-total correlation

Bergen Social Media Addiction Scale (BSMAS)

B1: Use a lot of time thinking about or planning using social media 3.12 (1.05) 0.72 0.76 3.18 (1.10) 0.68 0.72
B2: Felt an urge to use social media more and more 2.76 (0.96) 0.68 0.72 2.90 (1.05) 0.77 0.78
B3: Used social media to forget about personal problems 2.11 (0.97) 0.63 0.68 2.19 (0.96) 0.60 0.64
B4: Tried to cut down on the use of social media without success 2.34 (1.00) 0.67 0.71 2.43 (0.93) 0.59 0.63
B5: Got troubled by being prohibited from social media use 2.00 (0.90) 0.62 0.66 2.17 (0.93) 0.54 0.61
B6: Used social media too much to negatively impact on your job 2.25 (0.99) 0.61 0.65 2.40 (0.99) 0.54 0.59

Smartphone Application-Based Addiction Scale (SABAS)

S1: My smartphone is the most important thing in my life 4.04 (1.32) 0.32 0.34 4.72 (1.38) 0.49 0.55
S2: My smartphone use results in conflicts 2.47 (1.20) 0.44 0.46 2.90 (1.54) 0.48 0.52

5
S3: Preoccupying myself with my smartphone is a way of changing my mood 3.45 (1.34) 0.59 0.60 4.18 (1.44) 0.58 0.61
S4: I fiddle around more and more with my smartphone. 3.59 (1.31) 0.71 0.73 4.14 (1.39) 0.61 0.65
S5: If I cannot use my smartphone when I feel like, I feel sad 2.91 (1.30) 0.66 0.68 3.06 (1.36) 0.64 0.68
S6: If I try to cut the time I use my smartphone, I end up using it as much or more than before. 2.95 (1.31) 0.78 0.79 3.20 (1.25) 0.68 0.69

Internet Gaming Disorder Scale-Short Form (IGDS-SF9)

I1: Do you feel preoccupied with your gaming behavior? 2.10 (1.05) 0.83 0.82 2.41 (1.18) 0.84 0.81
I2: Do you feel more irritability, anxiety or even sadness when you try to either reduce or stop your gaming activity? 1.79 (0.82) 0.84 0.85 1.93 (0.87) 0.83 0.86
I3: Do you feel the need to spend increasing amount of time engaged gaming in order to achieve satisfaction or pleasure? 1.99 (0.97) 0.75 0.76 2.10 (1.01) 0.80 0.81
I4: Do you systematically fail when trying to control or cease your gaming activity? 1.89 (0.90) 0.82 0.84 2.04 (0.97) 0.79 0.82
I5: Have you lost interests in previous hobbies because of your engagement with gaming? 1.72 (0.83) 0.72 0.78 1.84 (0.90) 0.67 0.74
I6: Have you continued your gaming activity despite knowing it was causing problems between you and other people? 1.72 (0.87) 0.73 0.80 1.79 (0.96) 0.79 0.85
I7: Have you deceived any of your important others because the amount of your gaming activity? 1.44 (0.71) 0.54 0.68 1.62 (0.85) 0.65 0.74
I8: Do you play to temporarily escape or relieve a negative mood? 2.21 (1.05) 0.64 0.69 2.46 (1.14) 0.77 0.79
I9: Have you jeopardized an important relationship, job or an educational or career opportunity because of your gaming activity? 1.38 (0.75) 0.54 0.72 1.55 (0.81) 0.66 0.77

Note: Factor loadings were reported as standardized coefficients using configural model in the confirmatory factor analysis. The IGDS-SF9 was analyzed using multiple indicators and multiple causes (MIMIC) model with
gamer/non-gamer as a controlled variable.
Addictive Behaviors 101 (2020) 105969
H. Leung, et al. Addictive Behaviors 101 (2020) 105969

Table 3 indices). Unlike the findings from Pontes et al. (2017) and those from
Fit indices for confirmatory factor analysis stratified by Hong Kong and Taiwan. Stavropoulos et al. (2018), the results of the present study demon-
Hong Kong Taiwan (N = 336) Suggested cutoff strated a fully supported invariance across Hong Kong and Taiwan
(N = 306) university students in the Chinese IGDS-SF9.
Two possible reasons are proposed here to explain the different
BSMAS
measurement invariance findings between the English IGDS-SF9 and
χ2 (df)/ p-value 11.24 (9)/ 0.26 26.86 (9)/ 0.001 n.s.
CFI 0.996 0.967 > 0.9
Chinese IGDS-SF9. First, the cultural differences could be larger in the
TLI 0.994 0.945 > 0.9 two previous studies (Pontes et al., 2017; Stavropoulos et al., 2018)
RMSEA (90% CI) 0.031 (0.000, 0.080) 0.081 (0.047, < 0.08 than in the present study. The subsamples in the study of Pontes et al.
0.117) (2017) were recruited from the United States, United Kingdom, and the
SRMR 0.052 0.074 < 0.08
India, which are located in three continents (i.e., North America,
WRMR 0.732 1.131 <1
Europe, and South Asia). Similarly, the subsamples in the study of
SABAS
Stavropoulos et al. (2018) were recruited from three continents: North
χ2 (df)/ p-value 5.13 (9)/ 0.82 11.02 (9)/ 0.28 n.s.
CFI 1.000 0.996 > 0.9 America (the United States), Europe (United Kingdom), and Oceania
TLI 1.013 0.993 > 0.9 (Australia). In contrast, the subsamples in the present study were both
RMSEA (90% CI) 0.000 (0.000, 0.040) 0.026 (0.000, < 0.08 from South East Asia. Given that the geographical difference is larger
0.071) among the subsamples in the two studies on English IGDS-SF9, their
SRMR 0.030 0.044 < 0.08
WRMR 0.494 0.724 <1
subsamples were arguably more likely to have different lifestyles and
cultures, which subsequently contribute to the different interpretations
IGDS-SF9a
of items in the IGDS-SF9. On the other hand, Hong Kong and Taiwan
χ2 (df)/ p-value 27.79 (35)/ 0.80 37.35 (35)/ 0.36 n.s.
CFI 1.000 0.999 > 0.9 are viewed to have the subcultures within traditional Chinese culture
TLI 1.005 0.999 > 0.9 (Cheung & Chow, 1999). Additionally, Hong Kong and Taiwan are both
RMSEA (90% CI) 0.000 (0.000, 0.030) 0.016 (0.000, < 0.08 located in South East Asia and have close relationship. Therefore, it is
0.047) anticipated that Hong Kong and Taiwan people are likely to have si-
SRMR 0.052 0.056 < 0.08
WRMR 0.711 0.824 <1
milar lifestyles when interpreting the IGDS-SF9.
Second, the sample characteristics were not comparable between
BSMAS=Bergen Social Media Addiction Scale; SABAS=Smartphone the sample in the present study and the samples from previous studies.
Application-Based Addiction Scale; IGDS-SF9 = Internet Gaming Disorder In the present study university students were recruited with a narrow
Scale-Short Form; CFI = comparative fit index; TLI = Tucker-Lewis index; age range (SD = 4.02 years); Pontes et al. (2017) and Stavropoulos
RMSEA = root mean square error of approximation; SRMR = standardized root et al. (2018) recruited gamers with a wider age range
mean square residual; WRMR = weighted root mean square residual; (SD = 12.27 years and 6.38 years, respectively). Therefore, the sample
n.s. = nonsignificant; a Using multiple indicators and multiple causes (MIMIC)
here compared with the other two samples is less likely to have the
model with gamer/non-gamer as a controlled variable.
issue of generation gap. More specifically, in Pontes et al.'s study, the
youngest participant was aged 16 years and the oldest was aged 70
Another measurement invariance study on English IGDS-SF9 years. The interpretation of IGDS-SF9 items is therefore likely to be very
(Stavropoulos et al., 2018) showed similar findings to those of Pontes different because of the different growing experiences among their
et al. (2017) among gamers in the United States, United Kingdom, and participants. In contrast, in the present study, the sample had similar
Australia: unidimensional structure was supported and measurement ages between Hong Kong and Taiwan participants. Additionally, their
invariance was partially supported (loadings in Items 1, 2, and 5; in- educational levels were comparable. Therefore, the subsamples in the
tercepts in Items 1, 5, 7, and 9 were relaxed to achieve the satisfactory present study were likely to interpret the IGDS-SF9 items more similarly

Table 4
Measurement invariance across Hong Kong and Taiwan participants.
Configural modela Ladings constrained equala Ladings and thresholds constrained equala

BSMAS
χ2 (df) or ∆χ2 (∆df) 38.04 (18) 7.18 (5) 1.58 (5)
p-value 0.004 0.21 0.90
CFI or ∆CFI 0.982 −0.002 0.003
RMSEA or ∆RMSEA 0.063 −0.004 −0.010
SRMR or ∆SRMR 0.056 0.005 0.001

SABASb
χ2 (df) or ∆χ2 (∆df) 16.14 (18) 8.53 (4) 9.97 (3)
p-value 0.58 0.07 0.02
CFI or ∆CFI 1.000 −0.003 −0.007
RMSEA or ∆RMSEA 0.000 0.020 0.016
SRMR or ∆SRMR 0.033 0.008 0.007

IGDS-SF9c
χ2 (df) or ∆χ2 (∆df) 65.04 (70) 24.86 (8) 7.95 (8)
p-value 0.65 0.002 0.44
CFI or ∆CFI 1.000 0.002 0.000
RMSEA or ∆RMSEA 0.000 0.024 −0.001
SRMR or ∆SRMR 0.050 0.009 0.002

BSMAS=Bergen Social Media Addiction Scale; SABAS=Smartphone Application-Based Addiction Scale; IGDS-SF9 = Internet Gaming Disorder Scale-Short Form;
CFI = comparative fit index; RMSEA = root mean square error of approximation; SRMR = standardized root mean square residual.
a
Configural models are reported using χ2 (df), CFI, RMSEA, and SRMR; other models are reported using ∆χ2 (∆df), ∆CFI, ∆RMSEA, and ∆SRMR.
b
One factor loading (item S1) and two item thresholds (items S1 and S3) were relaxed in the constrained models.
c
Using multiple indicators and multiple causes (MIMIC) model with gamer/non-gamer as a controlled variable.

6
H. Leung, et al. Addictive Behaviors 101 (2020) 105969

Table 5
Correlations among time on social media, time on smartphone, time on gaming, Bergen Social Media Addiction Scale (BSMAS), Smartphone Application-Based
Addiction Scale (SABAS), and Internet Gaming Disorder Scale-Short Form (IGDS-SF9).
r (p-value)

Time on smartphone Time on gaming BSMAS SABAS IGDS-SF9

Entire sample
Time on social media 0.549 (< 0.001)⁎⁎⁎ 0.146 (< 0.001)⁎⁎⁎ 0.268 (< 0.001)⁎⁎⁎ 0.098 (0.014)⁎ −0.111 (0.008)⁎⁎⁎
Time on smartphone – 0.202 (< 0.001)⁎⁎⁎ 0.164 (< 0.001)⁎⁎⁎ 0.188 (< 0.001)⁎⁎⁎ −0.038 (0.37)
Time on gaming – – −0.151 (< 0.001)⁎⁎⁎ 0.111 (0.006)⁎⁎ 0.430 (< 0.001)⁎⁎⁎
BSMAS – – – 0.472 (< 0.001)⁎⁎⁎ 0.101 (0.018)⁎
SABAS – – – – 0.356 (< 0.001)⁎⁎⁎

Gamera
Time on social media 0.456 (< 0.001)⁎⁎⁎ 0.316 (< 0.001)⁎⁎⁎ 0.305 (< 0.001)⁎⁎⁎ −0.026 (0.73) −0.229 (0.002)⁎⁎
Time on smartphone – 0.190 (0.01)⁎ 0.154 (0.042)⁎ 0.191 (0.01)⁎ −0.195 (0.009)⁎⁎
Time on gaming – – −0.080 (0.29) 0.100 (0.18) 0.149 (0.048)⁎
BSMAS – – – 0.354 (< 0.001)⁎⁎⁎ 0.271 (0.001)⁎⁎
SABAS – – – – 0.459 (< 0.001)⁎⁎⁎

Non-gamera
Time on social media 0.608 (< 0.001)⁎⁎⁎ −0.057 (0.23) 0.267 (< 0.001)⁎⁎⁎ 0.155 (0.001)⁎⁎ −0.109 (0.03)⁎
Time on smartphone – −0.030 (0.53) 0.237 (< 0.001)⁎⁎⁎ 0.166 (< 0.001)⁎⁎⁎ −0.129 (0.01)⁎
Time on gaming – – −0.066 (0.17) 0.032 (0.50) 0.418 (< 0.001)⁎⁎⁎
BSMAS – – – 0.561 (< 0.001)⁎⁎⁎ 0.165 (0.001)⁎⁎
SABAS – – – – 0.300 (< 0.001)⁎⁎⁎

a
Whether the participants played online games regularly, and a gamer was defined as playing an online game at least one hour per week.
⁎
p < 0.05.
⁎⁎
p < 0.01.
⁎⁎⁎
p < 0.001.

than the subsamples in previous studies (Pontes et al., 2017; social media have various levels of overlap with each other. Strong
Stavropoulos et al., 2018). overlaps were found between WhatsApp and Smartphone Use Disorder,
Although the WRMR was slightly higher than the recommended while other social media applications (such as Facebook) had less
cutoff in the BSMAS for Taiwan participants (1.131 vs. 1), the present overlap. Future studies are therefore warranted to further delineate
authors believe that the unidimensional structure of the BSMAS is specific forms of internet addiction from generalized internet addiction.
supported for Taiwan participants. DiStefano, Liu, Jiang, and Shi There are some limitations in the present study. First, only uni-
(2018) recently conducted a simulation study and found that WRMR versity students were recruited, therefore the results cannot be gen-
“might provide misleading results under situations where extremely eralized to children, adolescents, and non-student adults (both young
large sample sizes are used” (p.1). They further suggested that “[r] and old). Also, participants from other Asian countries (e.g., mainland
esearchers might want to increase the cutoff (of WRMR) slightly (p12).” China, Malaysia and Singapore which also have Chinese-speaking citi-
Given that other fit indices (i.e., CFI, TLI, RMSEA, and SRMR) had sa- zens) were not included. Therefore the generalizability of the three
tisfactory performance, it is tentatively concluded that the unidimen- instruments across these Asian countries is unknown. Future studies
sional structure of the BSMAS is supported for Taiwan participants. recruiting a large sample with different ages and from different Asian
In addition, the measurement invariance was also fully supported countries are recommended. Second, the present study did not identify
for the Chinese BSMAS but not for the Chinese SABAS. Some implica- whether any participants were at risk of developing IGD, or whether
tions from the present findings can therefore be made; most notably any participants were at risk of developing of addictions to social media
that healthcare providers and researchers can compare social media or smartphone use. Therefore, the present study was unable to define
addiction between Hong Kong and Taiwan people using BSMAS be- the cutoff scores for the three instruments for healthcare providers to
cause of the supported measurement invariance. Comparisons on social screen for those at high-risk of developing an addiction to these beha-
media addiction between Hong Kong and Taiwan people can also be viors. Third, all the instruments were assessed using self-report.
carried out using the SABAS. However, some adjustments may be Consequently, the findings of the study may have been affected by
needed for Items 1 and 3 in the SABAS. More specifically, using CFA to biases due to memory recall or social desirability. Finally, the Hong
calculate latent scores in the SABAS rather than the summated item Kong participants had significantly fewer males than the Taiwanese
scores is more preferable for comparisons (Lin et al., 2013). Ad- participants in the study. Therefore, the comparisons between Hong
ditionally, given that this is the first study to examine the measurement Kong and Taiwan participants might not necessarily be representative.
invariance of the BSMAS and SABAS across different cultures, it was not
possible to compare the present study's findings to other studies. Future
5. Conclusion
studies are therefore needed to corroborate and compare the findings
here.
The present study found that the Chinese BSMAS, SABAS, and IGDS-
Nevertheless, the findings of the present study support the notions
SF9 were all adequate instruments to validly assess internet-related
made by prior research that distinguish specific internet addictions
addictions among university students. Additionally, the measurement
from generalized internet addiction, and that they are essential and
invariance across the two Chinese cultural areas (Hong Kong and
meaningful (Griffiths & Pontes, 2014; Montag et al., 2015). More spe-
Taiwan) was supported for all the instruments, except for one factor
cifically, the findings here suggest that BSMAS, SABAS, and IGDS-SF9
loading and two item thresholds in the SABAS. Researchers examining
were differently correlated between each other (i.e., more specifically,
the comparison between Hong Kong and Taiwanese individuals in their
addiction to social media is different from addiction to a smartphone
risk of developing social media addiction, smartphone application ad-
and addiction to gaming). Additionally, Sha, Sariyska, Riedl,
diction, and IGD will benefit from using the Chinese BSMAS, SABAS,
Lachmann, and Montag (2018) recently found that different types of
and IGDS-SF9.

7
H. Leung, et al. Addictive Behaviors 101 (2020) 105969

Acknowledgement disorder are not the same. Journal of Addiction Research and Therapy, 5, e124. https://
doi.org/10.4172/2155-6105.1000e124.
Hsu, C.-Y., & Wang, S.-M. (2018). Social entrepreneurial intentions and its influential
The study was supported by the Faculty Collaborative Research factors: A comparison of students in Taiwan and Hong Kong. Innovations in Education
Scheme between Social Sciences and Health Sciences, Faculty of Health and Teaching International. Advance online publication. doi. https://doi.org/10.1080/
and Social Sciences, the Hong Kong Polytechnic University. 14703297.2018.1427611.
Ip, C. Y., Liang, C., Wu, S.-C., Law, K. M. Y., & Liu, H.-C. (2018). Enhancing social en-
trepreneurial intentions through entrepreneurial creativity: A comparative study
Appendix A. Supplementary data between Taiwan and Hong Kong. Creativity Research Journal, 30(2), 132–142. https://
doi.org/10.1080/10400419.2018.1446744.
Jafari, P., Nozari, F., Ahrari, F., & Bagheri, Z. (2017). Measurement invariance of the
Supplementary data to this article can be found online at https:// Depression Anxiety Stress Scales-21 across medical student genders. International
doi.org/10.1016/j.addbeh.2019.04.027. Journal of Medical Education, 8, 116–122. https://doi.org/10.5116/ijme.58ba.7d8b.
Kuss, D. J., & Griffiths, M. D. (2012). Online gaming addiction in children and adoles-
cents: A review of empirical research. Journal of Behavioral Addictions, 1, 3–22.
References
https://doi.org/10.1556/JBA.1.2012.1.1.
Kuss, D. J., & Griffiths, M. D. (2017). Social networking sites and addiction: Ten lessons
American Psychiatric Association (2013). Diagnostic and statistical manual of mental dis- learned. International Journal of Environmental Research and Public Health, 14(3), 311.
orders (5th ed.). Washington, DC: American Psychiatric Association. https://doi.org/10.3390/ijerph14030311.
Andreassen, C. S., Billieux, J., Griffiths, M. D., Kuss, D. J., Demetrovics, Z., Mazzoni, E., & Kuss, D. J., Griffiths, M. D., Karila, L., & Billieux, J. (2014). Internet addiction: A sys-
Pallesen, S. (2016). The relationship between addictive use of social media and video tematic review of epidemiological research for the last decade. Current Pharmaceutical
games and symptoms of psychiatric disorder: A large-scale cross-sectional study. Design, 20, 4026–4052. https://doi.org/10.2174/13816128113199990617.
Psychology of Addictive Behaviors, 30(2), 252–262. https://doi.org/10.1037/ Kuss, D. J., Pontes, H. M., & Griffiths, M. D. (2018). Neurobiological correlates in Internet
adb0000160. Gaming Disorder: A systematic review. Frontiers in Psychiatry, 9, 166. https://doi.org/
Arıcak, O. T., Dinç, M., Yay, M., & Griffiths, M. D. (2018). Adapting the short form of the 10.3389/fpsyt.2018.00166.
internet gaming disorder scale into Turkish: validity and reliability. Addicta. https:// Laconi, S., Rodgers, R. F., & Chabrol, H. (2014). The measurement of Internet addiction: A
doi.org/10.15805/addicta.2019.6.1.0027 Epub ahead of print. critical review of existing scales and their psychometric properties. Computers in
Bányai, F., Zsila, Á., Király, O., Maraz, A., Elekes, Z., Griffiths, M. D., ... Demetrovics, Z. Human Behavior, 41, 190–202. https://doi.org/10.1016/j.chb.2014.09.026.
(2017). Problematic social media use: Results from a large-scale nationally re- Lin, C. Y., Broström, A., Nilsen, P., Griffiths, M. D., & Pakpour, A. H. (2017). Psychometric
presentative adolescent sample. PLoS One, 12(1), e0169839. https://doi.org/10. validation of the Persian Bergen Social Media Addiction Scale using classic test theory
1371/journal.pone.0169839. and Rasch models. Journal of Behavioral Addictions, 6(4), 620–629. https://doi.org/
Beard, K. W. (2005). Internet addiction: A review of current assessment techniques and 10.1556/2006.6.2017.071.
potential assessment questions. Cyberpsychology & Behavior, 8(1), 7–14. https://doi. Lin, C.-Y., Luh, W.-M., Cheng, C.-P., Yang, A.-L., Su, C.-T., & Ma, H.-I. (2013).
org/10.1089/cpb.2005.8.7. Measurement equivalence across child self-reports and parent-proxy reports in the
Beaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the Chinese version of the Pediatric Quality of Life Inventory Version 4.0. Child Psychiatry
process of cross-cultural adaptation of self-report measures. Spine, 25(24), & Human Development, 44(5), 583–590.
3186–3191. https://doi.org/10.1097/00007632-200012150-00014. Lin, C.-Y., Luh, W.-M., Yang, A.-L., Su, C.-T., Wang, J.-D., & Ma, H.-I. (2012).
Billieux, J., Maurage, P., Lopez-Fernandez, O., Kuss, D. J., & Griffiths, M. D. (2015). Can Psychometric properties and gender invariance of the Chinese version of the self-
disordered mobile phone use be considered a behavioral addiction? An update on report Pediatric Quality of Life Inventory Version 4.0: Short form is acceptable.
current evidence and a comprehensive model for future research. Current Addiction Quality of Life Research, 21, 177–182.
Reports, 2, 154–162. https://doi.org/10.1007/s40429-015-0054-y. Lin, C.-Y., Updegraff, J. A., & Pakpour, A. H. (2016). The relationship between the theory
Brand, M., Young, K. S., Laier, C., Wölfling, K., & Potenza, M. N. (2016). Integrating of planned behavior and medication adherence in patients with epilepsy. Epilepsy &
psychological and neurobiological considerations regarding the development and Behavior, 61, 231–236.
maintenance of specific Internet-use disorders: An Interaction of Person-Affect- Lin, M.-P., Wu, J. Y.-W., You, J., Hu, W.-H., & Yen, C.-F. (2018). Prevalence of internet
Cognition-Execution (I-PACE) model. Neuroscience & Biobehavioral Reviews, 71, addiction and its risk and protective factors in a representative sample of senior high
252–266. https://doi.org/10.1016/j.neubiorev.2016.08.033. school students in Taiwan. Journal of Adolescence, 62, 38–46. https://doi.org/10.
Chang, C.-C., Lin, C.-Y., Gronholm, P. C., & Wu, T.-H. (2018). Cross-validation of two 1016/j.adolescence.2017.11.004.
commonly used self-stigma measures, Taiwan versions of the Internalized Stigma Lin, Y.-H., Chang, L.-R., Lee, Y.-H., Tseng, H.-W., Kuo, T. B. J., & Chen, S.-H. (2014).
Mental Illness scale and Self-Stigma Scale-Short, for people with mental illness. Development and validation of the Smartphone Addiction Inventory (SPAI). PLoS
Assessment, 25(6), 777–792. https://doi.org/10.1177/1073191116658547. One, 9(6), e98312. https://doi.org/10.1371/journal.pone.0098312.
Chen, F. F. (2007). Sensitivity of goodness of fit indexes to lack of measurement in- Monacis, L., De Palo, V., Griffiths, M. D., & Sinatra, M. (2017). Social networking ad-
variance. Structural Equation Modeling, 14, 464–504. diction, attachment style, and validation of the Italian version of the Bergen Social
Chen, I.-H., Strong, C., Lin, Y.-C., Tsai, M.-C., Leung, H., Lin, C.-Y., ... Griffiths, M. D. Media Addiction Scale. Journal of Behavioral Addictions, 6(2), 178–186. https://doi.
(2019). Time invariance of three ultra-brief internet-related instruments: Smartphone org/10.1556/2006.6.2017.023.
Application-Based Addiction Scale (SABAS), Bergen Social Media Addiction Scale Monacis, L., Palo, V., Griffiths, M. D., & Sinatra, M. (2016). Validation of the Internet
(BSMAS), and the nine-item Internet Gaming Disorder Scale- Short Form (IGDS-SF9) Gaming Disorder Scale - Short-Form (IGDS9-SF) in an Italian-speaking sample.
(Study Part B). Addictive Behaviors. https://doi.org/10.1016/j.addbeh.2019.04.018. Journal of Behavioral Addictions, 5(4), 683–690. https://doi.org/10.1556/2006.5.
Cheng, C., & Li, A. Y. (2014). Internet addiction prevalence and quality of (real) life: A 2016.083.
meta-analysis of 31 nations across seven world regions. Cyberpsychology, Behavior and Montag, C., Bey, K., Sha, P., Li, M., Chen, Y. F., Liu, W. Y., ... Reuter, M. (2015). Is it
Social Networking, 17, 755–760. https://doi.org/10.1089/cyber.2014.0317. meaningful to distinguish between generalized and specific Internet addiction?
Cheung, G. W., & Chow, I. H.-S. (1999). Subcultures in Greater China: A comparison of Evidence from a cross-cultural study from Germany, Sweden, Taiwan and China.
managerial values in the People's Republic of China, Hong Kong, and Taiwan. Asia Asia-Pacific Psychiatry, 7(1), 20–26. https://doi.org/10.1111/appy.12122.
Pacific Journal of Management, 16(3), 369–387. de Palo, V., Monacis, L., Sinatra, M., Griffiths, M. D., Pontes, H. M., Petro, M., & Miceli, S.
Cook, K. F., Kallen, M. A., & Amtmann, D. (2009). Having a fit: Impact of number of items (2018). Measurement invariance of the nine-item Internet Gaming Disorder Scale
and distribution of data on traditional criteria for assessing IRT's unidimensionality across Albania, United States of America, United Kingdom, and Italy. International
assumption. Quality of Life Research, 18, 447–460. Journal of Mental Health and Addictions. https://doi.org/10.1007/s11469-018-9925-5
Csibi, S., Demetrovics, Z., & Szabo, A. (2016). Hungarian adaptation and psychometric Epub ahead of print.
characteristics of Brief Addiction to Smartphone Scale (BASS). In Hungarian Pantic, I. (2014). Online social networking and mental health. Cyberpsychology, Behavior
Psychiatria Hungarica, 31(1), 71–77. and Social Networking, 17(10), 652–657. https://doi.org/10.1089/cyber.2014.0070.
Csibi, S., Griffiths, M. D., Cook, B., Demetrovics, Z., & Szabo, A. (2018). The psychometric Pew Research Center (2016). Smartphone ownership and internet usage continues to
properties of the Smartphone Application-Based Addiction Scale (SABAS). climb in emerging economies. Retrieved July 17, 2018, from: http://www.
International Journal of Mental Health and Addiction, 16(2), 393–403. https://doi.org/ pewglobal.org/2016/02/22/smartphone-ownership-and-internet-usage-continues-
10.1007/s11469-017-9787-2. to-climb-in-emerging-economies/.
DiStefano, C., Liu, J., Jiang, N., & Shi, D. (2018). Examination of the weighted root mean Pontes, H. M., Andreassen, C. S., & Griffiths, M. D. (2016). Portuguese validation of the
square residual: Evidence for trustworthiness? Structural Equation Modeling, 25(3), Bergen Facebook Addiction Scale: An empirical study. International Journal of Mental
453–466. https://doi.org/10.1080/10705511.2017.1390394. Health and Addiction, 14, 1062–1073. https://doi.org/10.1007/s11469-016-9694-y.
Evren, C., Dalbudak, E., Topcu, M., Kutlu, N., Evren, B., & Pontes, H. M. (2018). Pontes, H. M., & Griffiths, M. D. (2015). Measuring DSM-5 internet gaming disorder:
Psychometric validation of the Turkish nine-item Internet Gaming Disorder Scale- Development and validation of a short psychometric scale. Computers in Human
Short Form (IGDS9-SF). Psychiatry Research, 265, 349–354. https://doi.org/10.1016/ Behavior, 45, 137–143. https://doi.org/10.1016/j.chb.2014.12.006.
j.psychres.2018.05.002. Pontes, H. M., & Griffiths, M. D. (2016). Portuguese validation of the Internet Gaming
Griffiths, M. D. (2000). Internet addiction – Time to be taken seriously? Addiction Disorder Scale-Short-Form. Cyberpsychology, Behavior and Social Networking, 19(4),
Research, 8(5), 413–418. https://doi.org/10.3109/16066350009005587. 288–293. https://doi.org/10.1089/cyber.2015.0605.
Griffiths, M. D. (2005). A ‘components’ model of addiction within a biopsychosocial Pontes, H. M., Stavropoulos, V., & Griffiths, M. D. (2017). Measurement Invariance of the
framework. Journal of Substance Use, 10, 191–197. https://doi.org/10.1080/ Internet Gaming Disorder Scale–Short-Form (IGDS9-SF) between the United States of
14659890500114359. America, India and the United Kingdom. Psychiatry Research, 257, 472–478.
Griffiths, M. D., & Pontes, H. M. (2014). Internet addiction disorder and internet gaming Pontes, H. M., Szabo, A., & Griffiths, M. D. (2015). The impact of Internet-based specific

8
H. Leung, et al. Addictive Behaviors 101 (2020) 105969

activities on the perceptions of internet addiction, quality of life, and excessive usage: inadequate concept. CNS Spectrums, 22(1), 7–13. https://doi.org/10.1017/
A cross-sectional study. Addictive Behaviors Reports, 1, 19–25. https://doi.org/10. S1092852915000863.
1016/j.abrep.2015.03.002. Stavropoulos, V., Beard, C., Griffiths, M. D., Buleigh, T., Gomez, R., & Pontes, H. M.
Ryan, T., Chester, A., Reece, J., & Xenos, S. (2014). The uses and abuses of Facebook: A (2018). Measurement invariance of the Internet Gaming Disorder Scale–Short-Form
review of Facebook addiction. Journal of Behavioral Addictions, 3, 133–148. https:// (IGDS9-SF) between Australia, the USA, and the UK. International Journal of Mental
doi.org/10.1556/JBA.3.2014.016. Health and Addiction, 16(2), 377–392. https://doi.org/10.1007/s11469-017-9786-3.
Schivinski, B., Brzozowska-Woś, M., Buchanan, E. M., Griffiths, M. D., & Pontes, H. M. Van den Brink, W. (2017). ICD-11 Gaming Disorder: Needed and just in time or dangerous
(2018). Psychometric assessment of the Internet Gaming Disorder diagnostic criteria: and much too early?: Commentary on: Scholars' open debate paper on the World
An Item Response Theory study. Addictive Behaviors Reports. https://doi.org/10. Health Organization ICD-11 Gaming Disorder proposal (Aarseth et al.). Journal of
1016/j.abrep.2018.06.004 Epub ahead of print. Behavioral Addictions, 6(3), 290–292. https://doi.org/10.1556/2006.6.2017.040.
van de Schoot, R., Lugtig, P., & Hox, J. (2012). A checklist for testing measurement in- Weinstein, A., & Lejoyeux, M. (2010). Internet addiction or excessive internet use.
variance. European Journal of Developmental Psychology, 9, 486–492. https://doi.org/ American Journal of Drug and Alcohol Abuse, 36(5), 277–283. https://doi.org/10.
10.1080/17405629.2012.686740. 3109/00952990.2010.491880.
Sha, P., Sariyska, R., Riedl, R., Lachmann, B., & Montag, C. (2018). Linking internet Wu, T.-H., Chang, C.-C., Chen, C.-Y., Wang, J.-D., & Lin, C.-Y. (2015). Further psycho-
communication and smartphone use disorder by taking a closer look at the Facebook metric evaluation of the Self-Stigma Scale-Short: Measurement invariance across
and WhatsApp applications. Addictive Behaviors Reports100148. https://doi.org/10. mental illness and gender. PLoS One, 10(2), e0117592. https://doi.org/10.1371/
1016/j.abrep.2018.100148. journal.pone.0117592.
Shek, D. T. L., & Leung, H. (2013). Development of an integrated intervention model for Wu, T.-Y., Lin, C.-Y., Årestedt, K., Griffiths, M. D., Broström, A., & Pakpour, A. H. (2017).
internet addiction in Hong Kong. International Journal of Child and Adolescent Health, Psychometric validation of the Persian nine-item Internet Gaming Disorder Scale -
6(4), 475–486. Short Form: Does gender and hours spent online gaming affect the interpretations of
Shek, D. T. L., & Yu, L. (2016). Adolescent internet addiction in Hong Kong: Prevalence, item descriptions? Journal of Behavioral Addictions, 6(2), 256–263. https://doi.org/
change, and correlates. Journal of Paediatric & Adolescent Gynecology, 29(1), S22–S30. 10.1556/2006.6.2017.025.
Sigerson, L., Li, A. Y., Cheung, M. W., Luk, J. W., & Cheng, C. (2017). Psychometric Yang, S.-Y., Chen, M.-D., Huang, Y.-C., Lin, C.-Y., & Chang, J.-H. (2017). Association
properties of the Chinese Internet Gaming Disorder Scale. Addictive Behaviors, 74, between smartphone use and musculoskeletal discomfort in adolescent students.
20–26. https://doi.org/10.1016/j.addbeh.2017.05.031. Journal of Community Health, 42, 423–430.
Starcevic, V., & Aboujaoude, E. (2017). Internet addiction: Reappraisal of an increasingly