Today, the excessive use of smartphones and screens, in general, is recognized as a major problem in our society. Recent world events that have led to individuals being confined to their homes for several months have intensified the amount of scientific and political concerns surrounding this issue. Excessive smartphone use can have dramatic consequences for the health and cognitive development of adolescents and young adults []. Indeed, difficulty in regulating smartphone use can lead to serious pathological disorders such as addiction to video games [].
Although health care professionals, researchers, and politicians recognize that excessive smartphone use is problematic, its legitimacy as a pathological disorder is not yet recognized by the American Psychiatric Association []. For this reason, the notion of problematic smartphone use is favored by a large number of researchers. Problematic smartphone use does, however, refer to symptoms of dependence such as loss of control, overuse, increased tolerance (ie, spending more time on the smartphone to be satiated), or withdrawal symptoms once individuals are no longer in possession of their smartphones [].
In order to identify individuals at risk of problematic use, the measurement of smartphone use practices is generally operationalized in research by using self-reported questionnaires. Three very recently published systematic reviews [-] identified 4 measurement scales most commonly used to measure problematic smartphone use, 3 of which are used with young adult students, that is, the Smartphone Addiction Scale [], the Nomophobia Questionnaire [], and the Problematic Use of Mobile Phones scale [], and 1 for adolescents, that is, the Smartphone Addiction Proneness Scale []. What these 4 scales have in common is that they assess problematic smartphone use across several dimensions, often inspired by the fourth and fifth versions of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV and DSM-V) [,].
The Smartphone Addiction Scale was designed by Kwon et al [] based on the diagnostic criteria for internet gaming addiction in DSM-IV []. It measures problematic smartphone use along 6 dimensions: disruption of daily life due to smartphone use, positive anticipation of use, withdrawal symptoms, overuse, tolerance, and importance of the virtual world for social relationships. This scale has the advantage of being validated in several languages, including English [], Arabic [], Brazilian [], Malaysian [], and Persian []. It also has good cross-cultural consistency, with Cronbach α ranging from 0.93 to 0.97. Although the Smartphone Addiction Scale has been translated and validated in French in a shorter 10-statement version [], the original 33-items scale has not been translated and validated in French.
The Nomophobia Questionnaire was designed by Yildirim and Correia [] and measures individuals’ fear of being separated from their smartphones. It measures 4 dimensions of smartphone separation fear: not being able to communicate, losing connection with the outside world, not being able to access information, and giving up comfort. According to the research work of Jahrami et al [], this questionnaire has been translated into 7 languages (eg, Chinese [], Italian []) and consistently has very good internal consistency (0.88≤α≤0.96).
The Problematic Use of Mobile Phones scale, designed by Merlo et al [], draws heavily on the criteria for online gaming addiction in DSM versions IV [] and V []. This scale considers 10 dimensions of problematic smartphone use in young adults: tolerance, withdrawal symptoms, smartphone use longer than expected, time spent on the smartphone, irrepressible desire to use the smartphone, abandonment or reduction of other activities, smartphone use despite physical and psychological consequences, smartphone use in risky situations, smartphone use despite social consequences, and inability to fulfill obligations due to use. Although being less validated, this scale has been translated into English [], German [], and Arabic [], and its consistency appears very satisfactory (0.90≤α≤0.94).
To date, 2 other scales measuring problematic smartphone use by young adults have been validated in French. The first scale, that is, the Implicit Association Test (smartphone) [] is strongly inspired by the internet addiction test developed by Young [] and not according to a set of diagnostic criteria for problematic smartphone use. However, the factor structures and internal consistency of the scale (α=0.93) were good. The other scale, that is, the Problematic Mobile Phone Use Questionnaire by Lopez-Fernandez et al [] is divided into 3 categories and has good internal consistency: dangerous use (α=0.81), prohibited use (α=0.74), and dependent use (α=0.90). The strength of this scale lies in its cross-cultural validity (eg, French, German, Hungarian, English, Finnish, Italian, Polish, Spanish), but surprisingly, it is one of the few scales that is not based on any version of DSM. However, recent research has shown that taking inspiration from gaming disorder criteria to measure problematic smartphone use is a way to better understand this phenomenon [].
The Smartphone Addiction Proneness Scale by Kim et al [] is inspired by the assessment criteria of Young’s [] Internet Addiction Test scale. To our knowledge, it is one of the few scales designed to measure problematic smartphone use in adolescents. The Smartphone Addiction Proneness Scale assesses 4 main dimensions: craving symptoms, tolerance, predominance of virtual life, and disruption of coping in daily life. To date, it has been translated into Korean (ie, translated from English) [], Malaysian [], German [], and Chinese []. The interrater internal consistency of this Korean scale is consistently acceptable (α=0.88).
Given the importance of completing proposals for measuring problematic smartphone use based primarily on the findings of DSM and to better understand this societal issue, the aim of this study is to linguistically translate the Smartphone Addiction Scale, the Nomophobia Questionnaire, the Problematic Use of Mobile Phones scale, and the Smartphone Addiction Proneness Scale to French so that they are conceptually equivalent to their original versions. The cross-cultural adaptation process will be performed using the forward/backward method, a commonly used method [-] and recommended by the World Health Organization []. The translation will be considered valid when the tests performed by the participants are considered conclusive. This step is a prerequisite for the quantitative validation of the questionnaires.
To assess the conceptual equivalence of the questionnaires, that is, whether the items in the original language have a similar meaning to the French version, we opted for the forward/backward translation method. This is the most commonly used technique for cross-cultural research, and we followed the recommendations of Epstein et al []. We have decided to validate these instruments for use exclusively in France.
Ethics ApprovalThis study was approved by the Grenoble Alpes University Hospital Center and has received ethics approval from the South-East I Ethics Committee for the Protection of Individuals (approval 2022-A01943-40).
QuestionnairesThe 4 questionnaires targeted for the cross-cultural procedure were as follows. The Smartphone Addiction Scale [] contains 33 items, and the response scale ranges from 1 (strongly disagree) to 6 (strongly agree). Each participant’s total score can range from 33 to 188 points, and a higher score indicates more problematic smartphone use. The Nomophobia Questionnaire [] contains 20 items, and the response scale ranges from 1 (strongly disagree) to 7 (strongly agree); each participant’s total score can therefore vary from 20 to 140 points, and a higher score indicates more problematic smartphone use. The Problematic Use of Mobile Phones scale contains 20 items []. The response scale ranges from 1 (not at all in agreement) to 5 (totally in agreement), and each participant’s total score can vary from 20 to 100 points, and a higher score indicates more problematic smartphone use. Finally, the Smartphone Addiction Proneness Scale by Kim et al [] contains 15 items. The response scale ranges from 1 (not at all in agreement) to 4 (totally in agreement), and each participant’s total score can vary from 15 to 60 points, and a higher score indicates more problematic smartphone use.
Forward TranslationThe first translation phase involved recruiting independent translators who were both 2 native French speakers bilingual in English and 2 native English speakers bilingual in French and asking them to translate the original English version into French. It was recommended that at least one of the translators knows the concept of the questionnaires to be measured and that at least one of them does not know the objective of the questionnaire. In this study, 4 qualified translators were involved: 2 translators were familiar with the concept of problematic smartphone use, while the other 2 were not. Two of the experts had backgrounds in health and psychology research: one was a novice and the other had prior experience in translation. At the end of the 4 translations, a single version was obtained after a reconciliation meeting of the 4 translators. Each questionnaire was checked for errors in spelling, grammar, punctuation, and translation of terminology and style against the original English version.
Backward TranslationIn the second phase, the French versions were retranslated into English by a native English speaker who had no clinical or medical expertise. The instructions that were given to the native English speaker were to translate each questionnaire literally. By comparing the translated English versions with the original questionnaires, the French translations were modified to be consistent with the originals. This step ensured the accuracy of the translations and highlighted any phrasing that could cause confusion.
Linguistic VerificationIn the third phase, 2 professionals familiar with the concept of problematic smartphone use were asked to comment and suggest modifications to the statements if necessary. We followed a universalist approach for equivalence, assessing conceptual, item, semantic, operational, measurement, and functional equivalence [].
Final VerificationThe final verification phase involved performing a preliminary pilot test with participants involved in the problem being measured to assess the clarity, intelligibility, and acceptability of the translations. Between December 2022 and June 2023, 18 French native speaker participants—10 students older than 18 years (ie, 6 girls and 4 boys) and 8 adolescents aged 12-17 years (ie, 6 girls and 2 boys)—completed the questionnaires for the final version during face-to-face interviews. Each interview lasted a maximum of 30 minutes. For minor participants, consent to take part in the study was obtained from the parents, while adult participants gave their own consent. Participants could be in good health or experiencing any medical condition and they could come from rural or urban areas in France. During the interviews, a researcher asked the participants questions such as “Did you understand the instructions, the items, and the response scales?”; “How did you interpret this item?”; or “What would you suggest as a reformulation?” The principal investigator checked the proofs of the final version and corrected any errors.
Data AnalysisTo analyze the qualitative data from the translation process, we employed a thematic approach focused on assessing the conceptual equivalence of the translated items. Responses from the participants during the individual interviews were transcribed and systematically analyzed to identify elements that could pose comprehension issues. Particular attention was given to semantic discrepancies between the original and translated versions as well as suggestions for reformulation provided by the participants. The data were then coded according to the types of mistranslations identified (eg, item comprehension, appropriateness of terms used) and grouped into recurring themes. This approach enabled us to evaluate the clarity and acceptability of the translations as well as to adjust the problematic items.
The age, gender, and specific cultural characteristics of the translators and the student and adolescent participants are detailed in .
Table 1. Age, gender, and cultural characteristics of the translators and the participants.Translation typeTranslators/participants (n)Mean age (years)GenderCultural characteristicsForward translation4 translators25.5 (range 20-31)2 females, 2 males2 native English, 2 native FrenchThe 4 translators translated the titles, dimensions, instructions, response modalities, and statements of each questionnaire. These 4 translations were synthesized into a consensual version A. Concerning questionnaire dimensions, a few terms were more difficult to translate from English to French. For example, the dimension “withdrawal” of the Smartphone Addiction Scale, the Problematic Use of Mobile Phones scale, and the Smartphone Addiction Proneness Scale was translated as “sevrage.” For the Nomophobia Questionnaire, 1 dimension was more challenging to translate into French: “giving up convenience.” The term “convenience” can have several meanings in French, but its translation as “confort” (comfort) appears to be the most appropriate, especially when defining this dimension as the loss of the comfort provided by smartphone use. The concept of “craving” for the Nomophobia Questionnaire is particularly complex to define in French as it does not have a direct equivalent. In clinical terms, craving corresponds to a strong impulsive desire to use one’s object of addiction, which in our context is the respondent’s smartphone use. Therefore, in French, we have defined this dimension as “désir” (desire). For the other dimensions, the terms used in French were mostly similar.
For the items in the Smartphone Addiction Scale, rather than using the infinitive form of verbs as proposed in the original version, we translated them by systematically beginning the verb with the first-person singular conjugation. For example, for the original item “missing planned work due to smartphone use,” we translated it as “J’oublie du travail planifié à cause de l’utilisation du smartphone.” This will help participants better understand the statements. Three statements were more difficult to translate into French: “feeling pleasant or excited while using a smartphone” and “feeling impatient and fretful when I am not holding my smartphone.” The term “pleasant” was suggested in French as “calme” (calm), and since the term “impatient” does not have a direct equivalent in French, we propose the homograph “impatient.” The verb “to annoy” present in 2 items of the Nomophobia Questionnaire required more debate regarding its translation. This term can imply constraint, boredom, or irritation depending on the context; therefore, we chose to translate it as “contrariété” (contrariety) to preserve the statement and its dimension without distorting it. The statement “using a smartphone is more enjoyable than spending time with family or friends” from the Smartphone Addiction Proneness Scale also sparked discussions among translators because not everyone agreed on how to translate “enjoyable.” This term can signify a pleasant or amusing moment depending on the context. Here, we opted for the most common translation, “agréable” (pleasant). For the other items, the differences in translation were minor and did not alter the literal meaning of the statements.
Backward TranslationFollowing this first translation, a native English translator backtranslated the questionnaires from the consensus version A into an English version B. This version B was compared to the original questionnaire in English. For the Smartphone Addiction Scale, 18 items were perfectly backtranslated, while 14 were slightly modified, but this did not alter their meaning and understanding. One item was retranslated, changing its meaning: “missing planned work due to smartphone use” was backtranslated as “I use my smartphone longer than planned.” We reworked this item in French to maintain its original meaning as “Je manque du travail planifié à cause de l’utilisation du smartphone.” For the Problematic Use of Mobile Phones scale, 17 statements were perfectly backtranslated, and the others underwent slight modifications without impacting their meaning and understanding. Backtranslation was even better for the Smartphone Addiction Proneness Scale, with 13 out of 15 items perfectly backtranslated and 2 having slight modifications without consequence. The backtranslation for the Nomophobia Questionnaire was satisfactory, with 10 out of 20 items varying slightly in wordings but without altering their meaning. The others were perfectly backtranslated. Thus, we obtained a translated version C for the 4 questionnaires.
Linguistic VerificationThe 2 researchers responsible for linguistic verification submitted 4 suggestions for conceptual modifications for the Smartphone Addiction Scale, 3 for the Nomophobia Questionnaire, and 1 for the Problematic Use of Mobile Phones scale, some of which were incorporated into the final C version. No additional modifications were suggested for the Smartphone Addiction Proneness Scale.
Final VerificationIn this final step, feedback from adolescents and students was minimal; therefore, we produced a final version D based on their input. Overall, they understood all the instructions, items, and response modalities well. Participants encountered no comprehension problems except for 3 items. For the Nomophobia Questionnaire, 2 students reported a comprehension difficulty with item 18. In English, it refers to checking “online connections and networks,” and we translated it as “online notifications and networks.” However, “online networks” made less sense than “social networks” for these students. We therefore modified the item. In addition, item 6 of the Problematic Use of Mobile Phones scale was difficult for one student to understand, as the translators had translated it by mixing the present and past tenses. We therefore modified the item from “J’ai pensé par le passé qu’il n’était pas normal de passer autant de temps sur le smartphone comme je le fais” to “Il m’est arrivé de penser qu’il n’était pas normal de passer autant de temps que moi à utiliser un smartphone.” In this way, students gained a better understanding of the item. Finally, item 22 of the Smartphone Addiction Scale had to be clarified, as 2 participants did not understand what “losing a friend” meant. In fact, the meaning of loss is important in French, as it could mean literally losing a friend through death or signify a friendship breakup. We have therefore clarified at the end of the item that this refers to friendship breakup in this context. The final translated versions are listed in -.
Table 2. Problematic Use of Mobile Phones scale translation.Item numberItem descriptionResponse methodsaEnglish translation: strongly disagree; French translation: fortement en désaccord.
bEnglish translation: strongly agree; French translation: fortement en accord.
cET: English translation.
dFT: French translation.
Table 3. Smartphone Addiction Scale translation.Item numberItem descriptionResponse methodsaEnglish translation: strongly disagree; French translation: fortement en désaccord.
bEnglish translation: disagree; French translation: en désaccord.
cEnglish translation: weakly disagree; French translation: un peu en désaccord.
dEnglish translation: weakly agree; French translation: un peu en accord.
eEnglish translation: agree; French translation: en accord.
fEnglish translation: strongly agree; French translation: fortement en accord.
gET: English translation.
hFT: French translation.
Table 4. Nomophobia Questionnaire translation.Item numberItem descriptionResponse methods
Comments (0)