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The TikTok Addiction Scale: Development and validation

Preprint · July 2024

DOI: 10.21203/rs.3.rs-4762742/v1

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The TikTok Addiction Scale: Development and validation
Petros Galanis

National and Kapodistrian University of Athens https://orcid.org/0000-0002-1308-5782

Aglaia Katsiroumpa
National and Kapodistrian University of Athens
Ioannis Moisoglou
University of Thessaly
Olympia Konstantakopoulou
National and Kapodistrian University of Athens

Research Article

Keywords: TikTok, addiction, scale, tool, instrument, validation, development

Posted Date: July 19th, 2024

DOI: https://doi.org/10.21203/rs.3.rs-4762742/v1

License:   This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License

Additional Declarations: The authors declare no competing interests.

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Abstract
Introduction: There is an absence of valid and specific psychometric tools to assess TikTok addiction. Considering that
the use of TikTok is increasing very rapidly, and the fact that TikTok addiction may be a different form of social media
addiction, there is an urge for a valid tool to measure TikTok addiction.

Aim: To develop and validate a tool to measure TikTok addiction among users.

Methods: First, we performed an extensive literature review to create a pool of items to measure TikTok addiction.
Then, we employed a panel of experts from different backgrounds to examine the content validity of the initial set of
items. We examined the face validity of the scale by performing cognitive interviews with TikTok users and calculating
the item-level face validity index. We employed exploratory and confirmatory factor analysis to examine the construct
validity of the “TikTok Addiction Scale” (TTAS). We examined the concurrent validity of the TTAS by using the “Bergen
Social Media Addiction Scale” (BSMAS), the Patient Health Questionnaire-4 (PHQ-4), and the Big Five Inventory‐10 (BFI‐
10). We used Cronbach’s alpha, McDonald’s Omega, Cohen’s kappa, and intraclass correlation coefficient to examine
the reliability of the TTAS.

Results: Initially, we developed a pool of 28 items and, after expert panel review and item analysis, we deleted 13 items.
Then, we conducted exploratory and confirmatory factor analysis including 15 items to examine the factorial structure
of the TTAS. Both analyses confirmed that the final version of the TTAS includes 15 items. Moreover, we found six
factors including 15 items; salience (two items), mood modification (two items), tolerance (three items), withdrawal
symptoms (two items), conflict (four items), and relapse (two items). Concurrent validity of the TTAS was excellent
since we found statistically significant correlations between the TTAS and the BSMAS, the PHQ-4, and the BFI‐10.
Cronbach’s alpha and McDonald’s Omega for the TTAS was 0.911 and 0.914, respectively. Cohen’s kappa for the 15
items ranged from 0.760 to 0.954 (p < 0.001 in all cases). Intraclass correlation coefficient for the TTAS was 0.994 (p <
0.001). Thus, the reliability of the TTAS was excellent.

Conclusions: The TTAS is a six-factor 15-item scale with robust psychometric properties. The TTAS is a short and easy-
to-use tool that measures levels of TikTok addiction among users in a valid way. Considering the limitations of our
study, we recommend the translation and validation of the TTAS in other languages and populations to further examine
the reliability and the validity of the scale.

Introduction
Social media platforms have gained immense popularity worldwide, with an estimated five billion people use these
platforms for connection, communication, and information seeking. Number of social media users has increased
worldwide from 2.7 billion in 2017 to 5.2 billion in 2023, a number projected to approach six billion in 2028. Moreover,
today the average daily social media usage is 151 minutes, while in 2012 was 90 minutes [1]. In the past year alone,
there has been a significant increase in the number of social media users, with approximately 300 million new users
joining the social media platforms. On average, a typical social media user interacts with or visits six different platforms
each month. Facebook has the greatest number of monthly active users (3.1 billion) following by YouTube (2.5 billion
users), Instagram (2 billion users), WhatsApp (2 billion users) and TikTok (1.6 billion users). One out of five people aged
18 and above around the world use TikTok. TikTok was downloaded more than 2 billion times in 2021, and most users
are adolescents and young adults (16–35 years old) [2].

TikTok has become one of the world's most widely used applications for short-form videos. Launched internationally in
2017, TikTok is a free social media platform that enables users to create, edit, and share brief video clips that are
enhanced with filters and feature the latest music trends. Users can download the application to their smartphones and

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record videos that are less than three minutes in length. TikTok offers a variety of features, including adding audio and
images, live broadcasting, and earning income based on the number of followers. Unlike other social media platforms
(e.g. Facebook, Twitter, Instagram, and Snapchat), which focus primarily on images and text, TikTok emphasizes on
brief videos [3]. TikTok's focus on short videos and interactive content has made it a popular choice for users seeking
quick, engaging entertainment. Users can earn income and attract followers by producing content, making the
application even more appealing. TikTok users prefer the application for various reasons, including social acceptance,
comfort, and satisfaction [4].

High levels of digital addiction raise concerns about the appropriate internet use. In particular, a meta-analysis including
data from 64 countries found that the global pooled prevalence for social media addiction is 17.4%, for internet
addiction is 14.2%, for smartphone addiction is 27%, for cybersex addiction is 8.2%, and for game addiction is 6% [5].
Also, prevalence of digital addiction was higher among low/lower-middle income countries and countries in Eastern
Mediterranean region. The growing trend of digital addiction over the past two decades has been exacerbated by the
COVID-19 pandemic. Another meta-analysis included 63 studies from 32 nations, and found that the pooled prevalence
of social media addiction is 24% worldwide, 31% in collectivist nations and 14% in individualist nations [6]. This finding
is supported by another recent meta-analysis included mainly studies that have been conducted during the COVID-19
pandemic [7]. In particular, this meta-analysis showed that the prevalence of problematic social media use is
significantly higher in low-income countries, and this difference is probably attributed to different socio-cultural
conditions between countries. Evidence regarding the impact of age on problematic social media use is controversial
since Cheng et al. [6] found higher prevalence among adolescents rather than both university students and community
adult samples, while Meng et al. [5] did not find differences related to age.

There is an ongoing debate over the negative consequences of social media usage. The excessive use of social media
is becoming a significant public health issue due to its association with various problems, such as depression, low self-
esteem, impulsivity, suicide risk, work impairments, and poor sleep quality [8–13]. A meta-analysis found a negative
correlation between problematic social media use and well-being, and a positive correlation between problematic social
media use and psychological distress [14]. Also, another recent meta-analysis showed a positive correlation between
problematic social media use and stress, anxiety, and depression among adolescents and young adults [15].
Additionally, internet-based addictive behaviors were increased during the COVID-19 pandemic mostly due to mental
health issues, problematic substance use, isolation, and financial issues [16].

TikTok empowers users to capture cherished memories and produce concise videos to document their lives, providing
ample entertainment. However, it is also emerging as a novel form of social media addiction [17]. Social media
addiction refers to the recurrence of addiction-like symptoms or a lack of self-restraint in relation to social media [18,
19]. Although research on social media addiction has concentrated predominantly on Facebook, Instagram, and other
well-established social media platforms, it has overlooked TikTok's influence and the associated maladaptive behaviors
[17]. Examining the behavior of TikTok addiction is essential for several reasons. Firstly, TikTok has rapidly grown to
become one of the most popular applications, surpassing other social media platforms in terms of user numbers and
usage intensity [3]. Secondly, TikTok boasts an advanced algorithm system, particularly in terms of participation,
content, and types of interaction, which makes TikTok addiction more severe than other social media platforms [17, 20,
21]. While the underlying negative effects of addiction are similar across different platforms, the intensity and driving
factors of TikTok addiction are unique [17]. Thirdly, TikTok's target audience is adolescents and young adults with short
attention spans. This has raised serious concerns as TikTok addiction is affecting young people seriously.

In this context, valid measurement of social media addiction/disorder/problematic use is crucial to identify high-risk
individuals. A recent scoping review found that there are 37 instruments that measure negative social networking site
use [22]. The Bergen Facebook Addiction Scale (BFAS) is the most widely instrument for measuring negative use of

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social media [23]. Several adaptations from the BFAS has been developed, such as the Bergen Social Media Addiction
Scale [24]. Other popular instruments include the Social Media Disorder Scale [25], the Facebook Intrusion
Questionnaire [26], the Generalized Problematic Internet Use Scale [27] and the Internet Addiction Test [28]. Lack of
consensus among scales makes it difficult to compare results among studies and ascertain the genuine extent of the
issue. Furthermore, the diverse range of instruments employed and the scarcity of a consensus concerning the cut-off
points for evaluating negative social media use underscore the obstacles and difficulties associated with measuring
this problem. Several scales do not even provide cut-off points, thus precluding the clear demarcation between regular
and negative usage. Additionally, several scales, such as the BFAS lack explicit cut-off points, opting instead to offer
suggestions; in such cases, individual scholars establish different cut-off points.

Until now, most studies have used simple variables to measure TikTok usage, such as time spent on TikTok, number of
accounts that participants follow, and number of friends, close friends, “likes” and “followers” [29–31]. Recently, two
studies used an adopted version of the BFAS to measure participants’ addiction on TikTok [32, 33]. In particular, these
studies just replaced the term “Facebook” with “TikTok” in the six items of the BFAS. Moreover, these studies did not
examine the validity of the scale refers to the TikTok items and, thus, use of the BFAS as a proxy for the TikTok
addiction is precarious. Additionally, Pontes et al. developed the Gaming Disorder Test (GDT) after the recognition of
gaming disorder as an official behavioral addiction and mental health disorder by the World Health Organization (WHO)
[34]. Authors developed four items to assess gaming activity both online and/or offline during the last 12 months.
Montag and Markett introduced the TikTok Use DisorderQuestionnaire (TTUDQ) by adapting the four GDT items [35]. In
particular, they replaced the term “gaming” with “TikTok use” in the four GDT items, but they did not examine the validity
of the TTUDQ. Moreover, Montag and Markett pointed out that their study suffers by serious selection bias since they
recruited their sample after an advertisement for a study on cognitive failure. Thus, they obtained a non-typical sample
for TikTok users with a mean age of 41 years and a maximum age of 85 years.

Although there are a plenty of tools to measure social media, social network, internet, Facebook, and Instagram
addiction/disorder/problematic use, there is an absence of valid and specific psychometric tools to assess TikTok
addiction/disorder/problematic use. Considering that the use of TikTok is increasing very rapidly, and the fact that
TikTok addiction may be a different form of social media addiction, there is an urge for a valid tool to measure TikTok
addiction. Given the diversity in platform design among social media platforms, it is crucial to examine the impact of
TikTok usage on individuals' mental health. Different platforms may have varying effects on users, potentially leading to
distinct outcomes for their mental well-being. Additionally, previous research has disproportionately focused on
Facebook, while neglecting the popularity of TikTok and the associated concerns of maladaptive behaviors. Given the
limited literature on TikTok use compared to studies on other social media platforms, our study specifically focuses on
TikTok overuse. Therefore, the aim of our study was to develop and validate a tool to measure TikTok addiction.

Methods
Development of the scale
Figure 1 shows the development and validation of the TikTok Addiction Scale (TTAS). We followed several steps to
develop the items of the TTAS [36]. First, we performed a complete and thorough literature review to identify
instruments, scales ant tools that measure social media, social network, internet, Facebook, and Instagram
addiction/disorder/problematic use [22–28, 37–39]. Literature suggests that addiction involves six core components:
(1) salience (preoccupation with social media), (2) mood modification (social media use improves mood), (3) tolerance
(increasing amounts of social media use are required to satisfy users), (4) withdrawal (users experience negative
feelings when social media use is discontinued or suddenly reduced), (5) conflict (social media use causes problems
and conflicts in work/education, relationships, sleep, and other activities), and (6) relapse (users revert to previous
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patterns of social media use after abstinence or control) [40–42]. In a similar way, the WHO has recently defined in the
11th Revision of the International Classification of Diseases (ICD-11) gaming disorder as a pattern of gaming behavior
or otherwise digital-gaming behavior [43]. It is the first time that any type of social media addiction is defined as a
disorder in the ICD. In this context, gaming disorder is characterized by loss of control, increasing priority given to
gaming over essential daily activities, functional impairments, and continuation of gaming despite negative
consequences. Emphasis is given on that symptoms of social media disorder/addiction should last for at least 12
months. Therefore, WHO definition for the gaming disorder is in accordance with the core components of addiction that
we mention above. For instance, increasing priority given to gaming over essential daily activities refers to the
component “conflict”. After all, we developed 28 items to measure TikTok addiction based on the six core components
of addiction, i.e. salience (four items), mood modification (five items), tolerance (five items), withdrawal (two items),
conflict (ten items) and relapse (two items).

Afterwards, we employed a panel of 10 experts from different backgrounds (e.g., psychologists, mental healthcare
professionals, physicians, sociologists, and nurses) to examine the content validity of the initial set of 28 items. We
asked experts to rate how well each of the 28 items corresponds to TikTok addiction among users. We offered experts
three options to evaluate each item; “not essential”, “useful but not essential” or “essential”. After experts’ evaluation we
calculated the content validity ratio for each item as follows:

N
n −
2
Content validity ratio =
N

In the formula above, “n” was the number of experts who rate an item as “essential”, while N was the total number of
experts (= 10). We retained items with content validity ratio greater than 0.80 as literature suggests [44]. In this step, we
removed eight items and, thus, 20 items were remained in our scale; four items refers to salience, four items refers to
mood modification, four items refers to tolerance, two items refers to withdrawal, four items refers to conflict, and two
items refers to relapse.

Then, we examined the face validity of the TTAS by performing cognitive interviews with five TikTok users [45]. All users
interpreted the 20 items as we intended. Furthermore, we conducted a pilot study with 15 TikTok users (eight males
and seven females, mean age; 22.7 years) to examine the clarity of the 20 items by calculating the item-level face
validity index. We asked TikTok users to rate the clarity of the 20 items. Answers were on a four-point Likert scale: 1 =
item is not clear; 2 = item is somewhat clear; 3 = item is quite clear and; 4 = item is highly clear). Then, we calculated the
item-level face validity index, and we kept items with values greater than 0.80 as literature suggests [46]. Face validity
index ranged from 0.866 to 1.000 and, thus, we kept all 20 items in our scale.

Twenty items (e.g., “During the last 12 months, I feel good when I upload videos on TikTok”, “During the last 12 months,
I think about how I could reduce my work/study to spend more time on TikTok”, “During the last 12 months, I feel sad
when I cannot use TikTok for some time”) were rated on a five-point Likert scale as follows: very rarely (1), rarely (2),
sometimes (3), often (4), very often (5). Higher scores indicate greater TikTok addiction. Supplementary Table 1 shows
the 20 items that were produced after the initial development phase of the TTAS.

Participants and procedure

We developed the TTAS in Greek. Our study population included adults aged 18 years or older that were being able to
read and understand Greek. Moreover, our participants must be TikTok users for at least the last 12 months. We
created an anonymous online version of the study questionnaire through Google forms. We collected our data through

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several ways; dissemination through social media (i.e., TikTok, Facebook, Instagram, Viber, and WhatsApp), face-to-face
interviews, and e-mail campaigns. We collected our data during July 2024.

Final overall sample included 429 TikTok users. Among our participants, 81.8% were females (n = 351) and 18.2% were
males (n = 78). Mean age of our sample was 26.5 years (standard deviation; 8.5), with a median value of 22 years
(minimum age; 18, maximum age; 54). Participants reported a mean time of TikTok use of 2.2 hours daily (standard
deviation; 1.6 hours, median; 2 hours; minimum value; 15 minutes, maximum value; 8 hours).

Item analysis
We employed an item analysis for the 20 items that were produced after the initial development phase of the TTAS. We
used the overall sample to check inter-item correlations, corrected item-total correlations, floor and ceiling effects,
skewness, kurtosis, and Cronbach’s alpha (when a single item was deleted) for our 20 items [47]. Literature suggests
that acceptable values for inter-item correlation range from 0.15 to 0.75 [48], and for item-total correlation are higher
than 0.30 [49]. Floor or ceiling effects are considered when more than 85% of participants achieve the lowest or highest
possible score, respectively [50]. Items follow the normal distribution when skewness is between − 2 to + 2, and
kurtosis is between − 7 to + 7 [51].

Construct validity
We employed exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to examine the construct validity
of the TTAS. Literature suggests a minimum sample size for the EFA of 50 observations [52] of five observations per
item [47]. Also, minimum sample size for the CFA is 200 observations [53]. Our sample covered these requirements. In
particular, we split randomly our participants into two groups to perform EFA and CFA with different samples. Then, we
used 169 TikTok users to conduct the EFA, and 260 TikTok users to conduct the CFA. Therefore, we used two different
samples to perform EFA and CFA to improve validity of our analyses. Our samples in both cases covered the sample
requirements for EFA and CFA.

First, we performed EFA to explore the underlying factor structure of the TTAS, and then we employed CFA to verify the
results of EFA. In this step, we included the 15 items that emerged after the initial development of the TTAS and the
item analysis.

We calculated the Kaiser-Meyer-Olkin index and p-value for Bartlett sphericity test to examine suitability of our data to
perform EFA. Acceptable values for the Kaiser-Meyer-Olkin index and Bartlett sphericity test are > 0.80 and < 0.05,
respectively [51]. We used oblique rotation (promax method in SPSS) to perform EFA since we expected significant
correlations between potential factors that were developed from the analysis. Acceptable values for the EFA are the
following: eigenvalues > 1, factor loadings > 0.60, communalities > 0.40, and the total variance explained by the factors
> 65% [51]. Additionally, we calculated Cronbach’s alpha for the factors that were produced by the EFA with values > 0.7
considered to be acceptable [54].

After EFA, we performed CFA to confirm the validity of the TTAS factor structure. The TTAS followed normal distribution
and, thus, we used the maximum likelihood estimator. We checked the goodness of fit indices in CFA by calculating two
indices of absolute fit (i.e., root mean square error of approximation [RMSEA] and goodness of fit index [GFI]), two
indices of relative fit (i.e., normed fit index [NFI] and comparative fit index [CFI]), and one index of parsimonious fit (i.e.,
chi-square/degree of freedom [x2/df]). Acceptable values for fit indices in CFA are the following: RMSEA < 0.10, GFI >
0.90, NFI > 0.90, CFI > 0.90, and x2/df < 5 [50, 55–57]. Additionally, we calculated standardized regression weights
between items and factors, and correlation coefficients between factors.
Concurrent validity
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Concurrent validity of the TTAS was investigated using the Bergen Social Media Addiction Scale (BSMAS) [24], the
Patient Health Questionnaire-4 (PHQ-4) [58], and the Big Five Inventory-10 (BFI‐10) [59]. We checked the concurrent
validity of the TTAS on the overall sample (N = 429).

The BSMAS includes six items (e.g., During the last 12 months, do you spent a lot of time thinking about social media
or planned use of social media?). Answers are on a five-point Likert scale from 1 (very rarely) to 5 (very often). Total
score ranges from 6 to 30, and higher scores on the BSMAS indicate greater social media addiction. We used the valid
Greek version of the BSMAS [60]. In our study, Cronbach’s alpha for the BSMAS was 0.829, and McDonald’s Omega was
0.830.

Two recent systematic reviews suggested a correlation between social media overuse and depression and anxiety
symptoms [61, 62]. Thus, we used the PHQ-4 to further examine the concurrent validity of the TTAS. The PHQ-4
comprises four items (e.g., Over the last two weeks, how often have you been bothered by feeling nervous, anxious or
on edge?), and assess anxiety and depression. Answers are on a four-point Likert scale from 0 (not at all) to 3 (nearly
every day). Total score ranges from 0 to 12, and higher scores on the PHQ-4 indicate greater anxiety and depression.
We used the valid Greek version of the PHQ-4 [63]. In our study, Cronbach’s alpha for the PHQ-4 was 0.818, and
McDonald’s Omega was 0.825.

Several studies support the positive correlation between social media addiction and neuroticism [64–66]. Moreover,
literature found a negative correlation between social media addiction and conscientiousness [66]. Therefore, we used
the BFI-10 to examine the concurrent validity of the TTAS. The BFI‐10 is a 10-item scale that measures the domains of
the five-factor model of personality: neuroticism, extraversion, openness, agreeableness, and conscientiousness. Each
factor includes two items. A sample item is the following: “I see myself as someone who is reserved”. Answers are on a
five-point Likert scale from 1 (strongly disagree) to 5 (strongly agree). Total score for each factor ranges from 2 to 10.
Higher scores on the BFI‐10 indicate greater neuroticism, extraversion, openness, agreeableness, and
conscientiousness. We used the valid Greek version of the BFI‐10 [67]. In our study, Cronbach’s alpha for the BFI‐10 was
0.712, and McDonald’s Omega was 0.714.

We measured the overall score for the scale and the six factors that emerged from the factor analysis. Specifically, we
summed the responses for all items and divided the total by the number of items to determine the total score for the
scale. Likewise, scores for each factor were calculated. All the scores ranged from one to five, with higher scores
indicating greater levels of TikTok addiction.

Afterwards, we expected a positive correlation between the TTAS and the BSMAS, the PHQ-4, and neuroticism.
Moreover, we expected a negative correlation between the TTAS and extraversion, openness and conscientiousness.

Reliability
First, we used the overall sample (N = 429) to assess the reliability of the TTAS. In particular, we calculated Cronbach’s
alpha and McDonald’s Omega for the TTAS and the factors. Acceptable values for Cronbach’s alpha and McDonald’s
Omega are > 0.6 [54].

Additionally, we measured corrected item-total correlations and Cronbach’s alpha when a single item was deleted for
the 15 items of the TTAS. Acceptable values for corrected item-total correlations were ≥ 0.30 [49].

Moreover, we performed a test-retest study with 30 TikTok users. In that case, participants completed the TTAS twice in
one week. We measured Cohen’s kappa for the 15 items of the TTAS since the answers were in an ordinal scale. Also,
we measured the two-way mixed intraclass correlation coefficient (absolute agreement) for the total score of TTAS, and
for scores on six factors.

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Ethical considerations
We collected our data in an anonymous and voluntary basis. We informed participants about the aim and the design of
our study and they gave their informed consent. The Ethics Committee of the Faculty of Nursing, National and
Kapodistrian University of Athens approved our study protocol (approval number; 451, June 2023). Moreover, we
conducted our study in accordance with the Declaration of Helsinki [68].
Statistical analysis
We use absolute numbers and percentages to present categorical variables. Also, we use mean, standard deviation,
median, minimum value and maximum value to present continuous variables. We employed the Kolmogorov-Smirnov
test and Q-Q plots to examine the distribution of scores on our scales. Scores on TTAS, BSMAS, PHQ-4 and BFI-10
followed normal distribution. Thus, we calculated Pearson’s correlation coefficient to examine correlation between
scales. P-values less than 0.05 were considered as statistically significant. We performed CFA with AMOS version 21
(Amos Development Corporation, 2018). All other analyses were conducted with IBM SPSS 21.0 (IBM Corp. Released
2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.).

Results
Item analysis
We present results from the item analysis in the Table 1; descriptive statistics, corrected item-total correlations, floor
and ceiling effects, skewness, kurtosis, and Cronbach’s alpha when a single item was deleted. Moreover, we present
inter-item correlations between the 20 items that were produced after the initial development phase of the TikTok
Addiction Scale in the Supplementary Table 2.

We deleted items #1, #4, #5, #6 and #12 due to low inter-item correlations with several other items. Moreover, items #1
and #5 had negative inter-item correlations with other items, while item #5 had low corrected item-total correlation
(0.268). Cronbach’s alpha for the 20 items was 0.896 and was decreased after removal of each single item. Moreover,
we examined the meaning of retained and excluded items in a theoretical way to judge the validity of item analysis. All
items that were removed after item analysis had items with similar meaning that were retained. For instance, the item
#1 had a similar meaning with the item #2, the item #4 with the item #3, the item #5 with the item #7, the item #6 with
the item #8, and the item #12 with the item #11.

Therefore, we deleted five items (#1, #4, #5, #6, #12, Table 1), and the remaining 15 items had acceptable corrected
item-total correlations, inter-item correlations, floor and ceiling effects, skewness and kurtosis. Cronbach’s alpha for the
15 items was 0.916.

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 Table 1
Descriptive statistics, corrected item-total correlations, floor and ceiling effects, skewness, kurtosis, and Cronbach’s
alpha (when a single item was deleted) for the 20 items that were produced after the initial development phase of the
TikTok Addiction Scale (N = 429).
Item Mean Corrected Floor Ceiling Skewness Kurtosis Cronbach’s Item
(standard item-total effect effect alpha if exclusion
deviation) correlation (%) (%) item or
deleted retention

1. I spend a lot 1.42 0.316 73.0 0.0 1.76 2.12 0.889 Excluded
of time thinking (0.77)
about what
videos should
upload on
TikTok

2. I think about 1.57 0.520 58.7 0.2 1.33 1.32 0.884 Retained
how I could (0.79)
reduce my
work/study to
spend more
time on TikTok

3. I have TikTok 1.94 0.628 41.3 1.9 0.87 0.24 0.881 Retained
in my mind even (0.98)
when I am not
using it

4. I feel 1.35 0.350 74.8 0.0 1.93 3.08 0.888 Excluded

compelled to (0.66)
upload videos
on TikTok soon
after an event

5. I feel good 1.77 0.268 60.1 1.4 1.11 0.04 0.892 Excluded
when I upload (1.07)
videos on
TikTok

6. My mood is 2.02 0.321 54.5 5.1 0.88 -0.61 0.892 Excluded

improved when (1.30)
I get
likes/comments
for my videos

7. I feel calm 3.27 0.333 5.8 6.3 -0.53 0.04 0.889 Retained
when I use (0.96)
TikTok

8. I use TikTok 3.43 0.549 6.8 20.7 -0.35 -0.61 0.883 Retained
as a get away (1.16)
from my
problems and
my thoughts

9. I have had 3.27 0.662 9.1 19.1 -0.19 -0.87 0.879 Retained
difficulties (1.22)
controlling the
time I spend on
TikTok

10. I have had 3.00 0.641 12.4 12.8 0.01 -0.78 0.880 Retained
difficulties (1.19)
closing TikTok

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 Item Mean Corrected Floor Ceiling Skewness Kurtosis Cronbach’s Item
(standard item-total effect effect alpha if exclusion
deviation) correlation (%) (%) item or
deleted retention

11. I want to 2.36 0.593 23.8 5.1 0.57 -0.12 0.881 Retained
use TikTok (1.08)
more and more

12. Ι use TikTok 3.08 0.347 17.2 20.0 -0.09 -1.24 0.891 Excluded
even in the (1.38)
bathroom

13. I feel bad 1.34 0.590 73.4 0.0 2.05 4.24 0.884 Retained
when I cannot (0.64)
use TikTok for
some time

14. I feel sad 1.30 0.574 75.1 0,0 1.71 1.96 0.885 Retained
when I cannot (0.55)
use TikTok for
some time

15. I don’t get 1.98 0.603 42.4 2.8 0.90 0.14 0.881 Retained
enough time to (1.06)
do things I want
to do because I
spend a lot of
time on TikTok

16. I lose sleep 2.47 0.614 23.8 5.8 0.41 -0.53 0.881 Retained
due to (1.14)
excessive use
of TikTok

17. I am not 2.20 0.691 35.9 5.6 0.76 -0.32 0.878 Retained
able to (1.19)
concentrate on
my work/study
due to TikTok
use

18. I use TikTok 1.97 0.627 47.6 4.4 1.04 0.16 0.880 Retained
so much that it (1.16)
has had a
negative impact
on my
work/study

19. I feel 1.63 0.534 59.7 0.7 1.33 1.09 0.884 Retained
depressed (0.89)
when I do not
use TikTok,
which goes
when I use it

20. I feel 1.70 0.577 57.6 0.5 1.13 0.27 0.882 Retained
anxious when I (0.94)
do not use
TikTok, which
goes when I use
it

Exploratory factor analysis

Page 10/22
The Kaiser-Meyer-Olkin index was 0.895, and p-value for Bartlett sphericity was < 0.001 indicating that our sample was
adequate to perform EFA. We employed oblique rotation (promax method) to perform our EFA including the 15 items
mentioned above (items #2, #3, #7, #8, #9, #10, #11, #13, #14, #15, #16, #17, #18, #19 and #20 in Table 1).

We found six factors including all items (Table 2). Therefore, our EFA confirmed the six-factor model for the TTAS that
we hypothesized in the Introduction. According to the literature, addiction involves salience, mood modification,
tolerance, withdrawal, conflict and relapse. Thus, our EFA identified the following factors: salience (two items; #1, #2),
mood modification (two items; #3, #4), tolerance (three items; #5, #6, #7), withdrawal symptoms (two items; #8, #9),
conflict (four items; #10, #11, #12, #13), and relapse (two items; #14, #15), (Table 2). The total variance explained by
the six factors was 80.703%. The variance explained by each single factor was as follows: 47.649% of the total variance
explained by the factor “conflict”, 9.605% of the total variance explained by the factor “tolerance”, 8.559% of the total
variance explained by the factor “withdrawal symptoms”, 5.823% of the total variance explained by the factor “salience”,
4.908% of the total variance explained by the factor “relapse”, and 4.159% of the total variance explained by the factor
“mood modification”. Factor loadings ranged from 0.733 to 0.939, while communalities ranged from 0.707 to 0.894.

Cronbach’s alpha for the TTAS was 0.916, while McDonald’s Omega was 0.923. Cronbach’s alpha and McDonald’s
Omega for the factors of the TTAS ranged from 0.659 to 0.868 (Supplementary Table 3).

Page 11/22
 Table 2
Exploratory factor analysis using oblique rotation (promax method) for the TikTok Addiction Scale (n = 169).
Item Factors Communalities

Conflict Tolerance Withdrawal Salience Relapse Mood

symptoms modification

1. I think about 0.391 0.350 0.443 0.866 0.344 0.224 0.770

how I could
reduce my
work/study to
spend more time
on TikTok

2. I have TikTok 0.599 0.528 0.555 0.796 0.358 0.220 0.707

in my mind even
when I am not
using it

3. I feel calm 0.196 0.288 0.191 0.075 0.370 0.903 0.845

when I use
TikTok

4. I use TikTok as 0.471 0.422 0.395 0.492 0.318 0.809 0.788

a get away from
my problems and
my thoughts

5. I have had 0.667 0.869 0.227 0.339 0.398 0.430 0.809

difficulties
controlling the
time I spend on
TikTok

6. I have had 0.699 0.888 0.427 0.499 0.306 0.266 0.843

difficulties
closing TikTok

7. I want to use 0.527 0.883 0.489 0.378 0.434 0.285 0.824

TikTok more and
more

8. I feel bad when 0.403 0.408 0.898 0.533 0.464 0.220 0.810
I cannot use
TikTok for some
time

9. I feel sad when 0.497 0.430 0.894 0.445 0.482 0.317 0.836
I cannot use
TikTok for some
time

10. I don’t get 0.829 0.592 0.442 0.488 0.439 0.059 0.767
enough time to
do things I want
to do because I
spend a lot of
time on TikTok

11. I lose sleep 0.733 0.664 0.220 0.105 0.485 0.423 0.722
due to excessive
use of TikTok

12. I am not able 0.917 0.663 0.392 0.449 0.486 0.324 0.847
to concentrate on

Page 12/22
 Item Factors Communalities

Conflict Tolerance Withdrawal Salience Relapse Mood

symptoms modification
my work/study
due to TikTok use

13. I use TikTok 0.876 0.528 0.474 0.487 0.355 0.307 0.804
so much that it
has had a
negative impact
on my
work/study

14. I feel 0.503 0.421 0.430 0.317 0.939 0.403 0.894

depressed when I
do not use
TikTok, which
goes when I use
it

15. I feel anxious 0.467 0.464 0.631 0.510 0.867 0.294 0.841
when I do not use
TikTok, which
goes when I use
it

Values express factors loadings. Bold indicate the highest factor loadings for the items.
Confirmatory factor analysis
Then, we performed CFA to verify the factors of the TTAS that obtained from the EFA. Thus, we performed CFA of 15
items across six factors. Our CFA suggested that the six-factor model with 15 items of the TTAS had very good fit to
data since x2/df was 1.481, RMSEA was 0.043, GFI was 0.953, NFI was 0.953, and CFI was 0.984. Moreover, the
correlation coefficients between factors were positive and statistically significant (p < 0.001 in all cases). In particular,
correlation coefficients ranged from 0.382 to 0.703. Standardized regression weights between 15 items and six factors
ranged from 0.473 to 0.921 (p < 0.001 in all cases). CFA of the TTAS is shown in Fig. 2.

In conclusion, our EFA and CFA identified a six-factor 15-item model for the TTAS; salience (two items; #1, #2), mood
modification (two items; #3, #4), tolerance (three items; #5, #6, #7), withdrawal symptoms (two items; #8, #9), conflict
(four items; #10, #11, #12, #13), and relapse (two items; #14, #15), (Supplementary Table 4).

Concurrent validity
We found a positive correlation between the TTAS and the BSMAS, suggesting that participants with higher levels of
social media addiction have also higher levels of TikTok addiction. In particular, correlation coefficients between the
TTAS and the BSMAS ranged from 0.475 to 0.744 (p < 0.01 in all cases).

Moreover, we found a positive correlation between the TTAS and the PHQ-4, suggesting that participants with higher
levels of anxiety and depression may have higher levels of TikTok addiction. In particular, correlation coefficients
between the TTAS and the PHQ-4 ranged from 0.163 to 0.371 (p < 0.01 in all cases).

Additionally, the six factors of the TTAS and the total score were correlated negatively with conscientiousness;
correlation coefficients ranged from − 0.406 to -0.210, p < 0.01 in all cases). Similarly, we found a negative correlation
between the extraversion and salience (r = -0.123, p < 0.05), mood modification (r = -0.226, p < 0.01), tolerance (r =

Page 13/22
-0.110, p < 0.05), conflict (r = -0.165, p < 0.05), relapse (r = -0.144, p < 0.01), and total score of the TTAS (r = -0.184, p <
0.01).

Also, we found a negative correlation between openness and withdrawal symptoms (r = -0.145, p < 0.01), and a positive
correlation between neuroticism and mood modification (r = 0.116, p < 0.05), and tolerance (r = 0.169, p < 0.01).

Therefore, the concurrent validity of the TTAS was excellent. Table 3 shows the correlations between the TTAS and the
BSMAS, the PHQ-4, and the BFI-10.

Table 3
Pearson’s correlation coefficients between the TikTok Addiction Scale (TTAS) and the Bergen Social Media
Addiction Scale (BSMAS), the Patient Health Questionnaire-4 (PHQ-4), and the Big Five Inventory-10 (BFI‐10) (n =
429).
TTAS BSMAS PHQ-4 BFI-10

Neuroticism Openness Extraversion Conscientiousness

Salience 0.509** 0.163** -0.014 -0.079 -0.123* -0.264**

Mood modification 0.475** 0.363** 0.116* -0.059 -0.226** -0.210**

Tolerance 0.601** 0.317** 0.169** -0.004 -0.110* -0.312**

Withdrawal symptoms 0.509** 0.181** -0.047 -0.145** -0.037 -0.270**

Conflict 0.649** 0.358** 0.063 -0.073 -0.165* -0.420**

Relapse 0.547** 0.266** 0.001 -0.091 -0.144** -0.248**

Total score 0.744** 0.371** 0.089 -0.083 -0.184** -0.406**

*
p < 0.05

**
p < 0.01

Reliability
We present Cronbach’s alpha and McDonald’s Omega for the six-factor model with 15 items for the TTAS in Table 4.
Cronbach’s alpha and McDonald’s Omega for the TTAS was 0.911 and 0.914, respectively. Moreover, Cronbach’s alpha
for the six factors ranged from 0.624 to 0.860, while McDonald’s Omega ranged from 0.862 to 0.879. Thus, the internal
consistency of the TTAS was very good.

Additionally, corrected item-total correlations had values between 0.333 and 0.756, while removal of each single item
did not increase Cronbach’s alpha (Supplementary Table 5).

Cohen’s kappa for the 15 items ranged from 0.760 to 0.954 (p < 0.001 in all cases), (Supplementary Table 6).
Additionally, intraclass correlation coefficient for the total score was 0.994 (95% confidence interval; 0.984 to 0.998, p <
0.001), while for the six factors ranged from 0.930 to 0.992 (p < 0.001 in all cases), (Supplementary Table 7). Thus, the
reliability of the TTAS was excellent.

Page 14/22
 Table 4
Cronbach’s alpha and McDonald’s Omega for the six-factor model
with 15 items for the TikTok Addiction Scale (n = 429).
Factor Cronbach’s alpha McDonald’s Omega

Salience 0.642 NC

Mood modification 0.624 NC

Tolerance 0.850 0.862

Withdrawal symptoms 0.847 NC

Conflict 0.873 0.879

Relapse 0.860 NC

TikTok Addiction Scale 0.911 0.914

NC: non computable due to limited items

Discussion
Only seven years after its initial release, TikTok has become one of the world's most widely used applications for short-
form videos since more than 20% of adults around the world use it [2]. Although research on social media addiction has
primarily focused on well-established platforms like Facebook, Instagram, and others, it has overlooked the influence of
TikTok and the related maladaptive behaviors [17]. Therefore, employing valid tools to assess TikTok addiction is
essential to identify high-risk individuals. A recent review revealed that there are 37 instruments that measure negative
social networking site usage, such as the Bergen Facebook Addiction Scale, the Social Media Disorder Scale, the
Facebook Intrusion Questionnaire, the Generalized Problematic Internet Use Scale, and the Internet Addiction Test [22].
However, no valid and specific psychometric tools exist to assess TikTok addiction/disorder/problematic use. Given the
rapid increase in TikTok usage and the fact that TikTok addiction may be a distinct form of social media addiction,
there is a need for a valid tool to measure TikTok addiction. Given the differences in platform design among social
media platforms, it is crucial to investigate the impact of TikTok usage on individuals' mental health. To the best of our
knowledge, no valid and specific tool exists to assess TikTok addiction.

In this context, we developed and validated a specific tool to measure TikTok addiction among users, i.e. the TikTok
addiction scale. Since the literature suggests that addiction involves six core components, namely salience, mood
modification, tolerance, withdrawal, conflict and relapse, we developed items for the TTAS according to this theoretical
framework [40–43]. After a thorough literature review [22–28, 37–39] we identified 28 items, and we deleted eight
items after examination of content validity and face validity. Then, we performed an item analysis for the 20 items that
were produced after the initial development phase of the TTAS, and we deleted five items due to low inter-item
correlations, negative inter-item correlations and low corrected item-total correlations.

Afterwards, we performed exploratory and confirmatory factor analysis to examine the construct validity of the TTAS.
Factor analysis identified six factors which explain 80.703% of the total variance of TikTok addiction. In particular, the
factors were the following: salience (two items), mood modification (two items), tolerance (three items), withdrawal
symptoms (two items), conflict (four items), and relapse (two items). The factor “conflict” explained the greatest
amount of the variance, and then the factors “tolerance” and “withdrawal symptoms”. In CFA, the RMSEA was 0.043, the
GFI was 0.953, the NFI was 0.953, and the CFI was 0.984, which indicate very good fit to our data [50, 55–57].
Additionally, the correlation coefficients between the six factors ranged from 0.382 to 0.703 and were statistically
significant (p < 0.001 in all cases). Thus, our factor analysis identified a six-factor 15-item model for the TTAS, and
Page 15/22
confirmed our hypothesis that TikTok addiction involves six components (i.e., salience, mood modification, tolerance,
withdrawal, conflict and relapse) as other addictions involve.

Additionally, we examined the concurrent validity of the TTAS by estimating the correlation between the TTAS and the
BSMAS [24], the PHQ-4 [58], and the BFI-10 [59]. In particular, we expected a positive correlation between the TTAS and
the BSMAS, the PHQ-4, and neuroticism. On the opposite, we expected a negative correlation between the TTAS and
extraversion, openness and conscientiousness. The concurrent validity of the TTAS was excellent since we found
moderate to high correlation coefficients between the TTAS and the BSMAS. As it was expected, the scores for the
TTAS are correlated with a specific social media measure of addiction, such as the Bergen Social Media Addiction
Scale. Moreover, we found positive and statistically significant correlations between the TTAS and the PHQ-4. Literature
confirms this finding since two recent systematic reviews found a positive correlation between social media overuse
and depression and anxiety symptoms [61, 62]. Also, we found that the higher the score on the TTAS, the higher the
score on neuroticism. Several studies showed the positive correlation between social media addiction and neuroticism
[64–66]. On the other hand, we found a negative correlation between the TTAS and conscientiousness. This finding is in
accordance with the literature since individuals with high levels of conscientiousness give less priority to social media
in order to accomplish their work [66].

Finally, we found that the reliability of the TTAS was excellent since Cronbach’s alpha and McDonald’s Omega for the
scale was 0.911 and 0.914, respectively. Moreover, Cronbach’s alpha for the six factors ranged from 0.624 to 0.860,
while McDonald’s Omega ranged from 0.862 to 0.879. Additionally, in the test-retest study we found that the intraclass
correlation coefficient for the TTAS was 0.994, while for the six factors ranged from 0.930 to 0.992.

Limitations
Our study had several limitations. First, we conducted our study in a particular country by employing a convenience
sample. For instance, compared with the general population, a relatively low percentage of males participated in our
study. Thus, our sample cannot be generalized and further studies with more representative samples and in different
setting (e.g. students, adolescents) should be conducted to further examine the validity of the TTAS. However, our
psychometric analysis is powerful since our sample size met all the requirements. Second, we did not perform our
study under clinical settings, and, thus, our findings should be used with concern in clinical practice for diagnosis.
Studies with well-controlled clinical settings would add significant information. For instance, identification of TikTok
addicted users through clinical examination by psychologists may help us to identify cut-off points for the TTAS, and
examine the predictive validity of the scale. Third, we used self-report scales to measure concurrent validity of the
TTAS, and, thus, information bias is probable. Fourth, we examined the concurrent validity of the TTAS by calculating
the correlation coefficients between the TTAS and three other scales, i.e. BSMAS, PHQ-4 and BFI-10. Future studies may
also use other scales to further validate the TTAS. Finally, we employed a cross-sectional design to examine the validity
of the TTAS. Since TikTok users’ attitudes may change throughout the time, longitudinal studies should investigate how
TikTok addiction levels change over time.

Conclusions
As far as we are aware, the TTAS is the first tool that specific measures levels of TikTok addiction among users. After a
thorough reliability and validity analysis we found that the TTAS is a short and easy-to-use tool with robust
psychometric properties. Our findings suggest that the TTAS is a six-factor 15-item scale that measures the six core
components of addiction (i.e., salience, mood modification, tolerance, withdrawal, conflict and relapse). Thus, the TTAS
may be used as a timely tool to measure levels of TikTok addiction and identify high-risk users, both in the community
and educational fields. Considering the limitations of our study, we recommend the translation and validation of the

Page 16/22
TTAS in other languages and populations to further examine the reliability and the validity of the scale. The TTAS could
be an effective means to measure the TikTok addiction, and may help policy makers, health educators, clinicians and
scholars to recognize high-risk groups for TikTok addiction.

Declarations
Funding None

Competing interests None

Ethical approval All procedures followed were in accordance with the ethical standards of the responsible committee
on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.
Informed consent was obtained from all participants for being included in the study.

Conflict of interest All authors declare that they have no conflict of interest.

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Figures

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Figure 1

Development of the TikTok Addiction Scale.

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Figure 2

Confirmatory factor analysis of the TikTok Addiction Scale.

Supplementary Files
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SupplementaryTables.docx

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