Amendola and colleagues (2025) examined the usefulness of Harmful Dysfunction Analysis (HDA) in identifying individuals with pathological social media disorder. Harmful Dysfunction Analysis, proposed by Wakefield et al (1992), is a framework for constructing diagnostic criteria, and suggests a disorder is a harmful dysfunction, and defines a dysfunction as a failure of an internal mechanism to perform its naturally designed function. One important distinction of HDA is that harmful consequences of behaviour in the absence of dysfunction does not mean a disorder is present. Both dysfunction and harm are required for diagnosis of a disorder
 
Their analysis is based on data from the Health Behaviour in School-aged Children study (specifically the Swiss sample, N = 7,510), which is a world health organisation collaborative cross-sectional study of adolescent well-being from 2018 (https://www.who.int/europe/initiatives/health-behaviour-in-school-aged-children-(hbsc)-study). They examined the 9-item Social Media Disorder Scale under DSM-5 and HDA categories (dysfunction and harm), and examine convergence between the scoring methods. 
 
Their findings suggested higher prevalence of problematic social media usage and gaming disorder prevalence (33.2 and 9%, respectively) using substance use disorder (DSM-5) compared to prevalence rates of 22.2% and 4.2% when using Harmful Dysfunction analyses. Sensitivity analyses demonstrated similarly findings in a sample of individuals from Hungary. They suggest that their findings might help to eliminate false positive diagnoses for individuals who engage in high intensity social media / gaming usage, that might be mistaken for a mental disorder.  However, as discussed by the authors caution is warranted findings are limited to adolescents (aged 11-15) and based on self-reported variables. 

 

The Stage 2 manuscript was evaluated by two expert reviewers across one round of in-depth review. Based on detailed responses to the reviewers' comments, the recommender judged that the manuscript met the Stage 2 criteria and awarded a positive recommendation.

 

URL to the preregistered Stage 1 protocol: https://osf.io/y3ub8
 
Level of bias control achieved: Level 3. At least some data/evidence that was used to the answer the research question had been previously accessed by the authors (e.g. downloaded or otherwise received), but the authors certify that they had not observed any part of the data/evidence prior Stage 1 to in-principle acceptance.
 
List of eligible PCI RR-friendly journals:
 

 

References
 
1. Amendola, S., Hengartner, M. P., & Wakefield, J. C. (2025). TThe Harmful Dysfunction Analysis applied to the concept of behavioral addiction: A secondary analysis of data from the Health Behaviour in School-aged Children 2018 [Stage 2]. Acceptance of Version 3 by Peer Community in Registered Reports. https://doi.org/10.31219/osf.io/atwgy_v3
 
2. Wakefield, J. C. (1992). Disorder as Harmful Dysfunction: A Conceptual Critique of DSM-III-R’s Definition of Mental Disorder. Psychological Review, 99, 232–247. https://psycnet.apa.org/doi/10.1037/0033-295X.99.2.232

 

Amendola and colleagues (2024) plan to examine the usefulness of Harmful Dysfunction Analysis (HDA) in identifying individuals with pathological social media disorder. Harmful Dysfunction Analysis, proposed by Wakefield et al (1992), is a framework for constructing diagnostic criteria, and suggests a disorder is a harmful dysfunction, and defines a dysfunction as a failure of an internal mechanism to perform its naturally designed function. One important distinction of HDA is that harmful consequences of behaviour in the absence of dysfunction does not mean a disorder is present. Both dysfunction and harm are required for diagnosis of a disorder

 

This analysis may provide a useful perspective on how to separate pathological social media use from high involvement. To examine their aims, the authors will conduct secondary analysis on data from the Health Behaviour in School-aged Children study (specifically the Swiss sample, N = 7,510), which is a world health organisation collaborative cross-sectional study of adolescent well-being from 2018 (https://www.who.int/europe/initiatives/health-behaviour-in-school-aged-children-(hbsc)-study). They will examine the 9-item Social Media Disorder Scale under DSM-5 and HDA categories (dysfunction and harm), and examine convergence between the scoring methods. Subsequent analyses will focus on groups defined by each scoring method (DSM vs HDA, with no overlapping cases) will be compared on measures of physical and mental health. Sensitivity analyses will be conducted in an independent sample from Hungary in 2023 (N = 3,789).

The Stage 1 manuscript was evaluated by three expert reviewers across two rounds of review. Following in-depth review and responses from the authors, the recommender judged that the Stage 1 criteria were met and awarded in-principle acceptance (IPA).
 

URL to the preregistered Stage 1 protocol: https://osf.io/y3ub8
 
Level of bias control achieved: Level 3. At least some data/evidence that will be used to the answer the research question has been previously accessed by the authors (e.g. downloaded or otherwise received), but the authors certify that they have not yet observed ANY part of the data/evidence.
 
List of eligible PCI RR-friendly journals:

 

 

References
 
1. Amendola, S., Hengartner, M. P., & Wakefield, J. C. (2024). The Harmful Dysfunction Analysis applied to the concept of behavioural addiction: A secondary analysis of data from the Health Behaviour in School-aged Children 2018. In principle acceptance of Version 3 by Peer Community in Registered Reports. https://osf.io/y3ub8
 
2. Wakefield, J. C. (1992). Disorder as Harmful Dysfunction: A Conceptual Critique of DSM-III-R’s Definition of Mental Disorder. Psychological Review, 99, 232–247. https://psycnet.apa.org/doi/10.1037/0033-295X.99.2.232