This 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). The collected data were anonymized throughout the analysis process, in compliance with the MR003 methodology approved by the National Commission on Informatics and Liberty. For minor participants, consent to participate was obtained from the teenagers and their parents. Adult participants gave their own consent. Furthermore, no compensation was provided to the participants.

The DASC questionnaire designed by Hawi et al [25] is composed of 25 statements distributed across 9 dimensions taken from the DSM-5 video game addictive disorder criteria [5]: preoccupation in daily life, tolerance, withdrawal symptoms, mood changes, social and psychological consequences, relapses, physiological problems, deception regarding its use, and family disconnection. In the absence of the original online guideline that introduces the questionnaire to the participants, we took inspiration from the PMUM scale [26] by specifying that we want to capture adolescents’ experiences with their screens (ie, television, video games, tablets, smartphones, portable game consoles, laptops, or computers). The adolescent must reflect on his or her experiences over the past year. The response scale ranges from 1=never to 5=always, and the total score can vary from 25 to 125.

The PMUM questionnaire is composed of 27 statements and was designed by Domoff et al [26], who based the instrument on the diagnostic criteria for online gaming addiction disorder in the DSM-5 [5]. The guideline consists of asking parents how their child uses screens (ie, television, video games, tablets, smartphones, portable game consoles, laptops, or computers). For each statement, they select the option that is true for their child during the last year. For each question, the response scale is from 1=never to 5=always; the total average score on this scale can vary from 1 to 5.

Data were analyzed using a qualitative approach with the forward and backward method, involving iterative interpretation of the interview responses. Descriptive statistics were conducted on the sample characteristics, such as age and gender. The qualitative analysis focused on identifying 4 key themes from the interviews.

The age, gender, and specific cultural characteristics of the translators, the parent and adolescent participants are detailed in Table 1

Four translators translated the titles, dimensions, guidelines, response categories, and statements of the 2 questionnaires. The 4 proposals were grouped to arrive at a consensual version. Although the titles, response categories, and guidelines did not pose a translation problem, there was less consensus on some dimension names. This mainly concerns the “withdrawal” dimension present in the 2 questionnaires, which has ultimately been translated as “sevrage.” The second, more problematic dimension to translate was that of the DASC scale: “displacement.” In the context of behavioral addiction, displacement corresponds to the implementation of intense or compulsive displacement behaviors when an individual is in a stressful situation [29]. We opted for the “déplacement” term that is adapted and used in French [30]. Similarly, for the DASC scale, although “device” is generally translated in French as “appareil,” we opted for “écrans” to better suit the context. For item 15, “enjoyable” offered multiple translation options, we translated it as “amusant” to adapt it to our context. For item 20, “I check my device…” had 4 different translations among the 4 translators as “to check” has a wide range of relevant translations. Therefore, we decided to translate it as “vérifier” even though it is not the most common word among all translation options, but as it is the most close translation from the original sentence without impacting the overall item meaning and conveying an intentional and repeating action. For item 25, “grades” was translated by “notes scolaires” as the raw translation “notes” would add too much ambiguity on the overall item.

For the PMUM questionnaire items, 23 of them were very similar between the 4 translations. Four items varied slightly for 1 or 2 translators. For instance, for item 10, the term “enjoys” offered multiple translation options; to achieve both semantic and idiomatic equivalence, we chose “apprécier,” resulting in: “Il n’y a rien que mon enfant n’apprécie autant que les écrans.” In 2 items, the term “amount of time” lacks a direct French equivalent. To preserve the operational and semantic meaning, we chose “la quantité de temps” for item 13 and “des périodes de plus en plus longues” for item 14. In item 22, the ambiguous term “sneaks” was resolved as “en cachette.”

As for the DASC questionnaire items, 22 reached consensus, and 3 items varied slightly for 1 or 2 translators. Although “device” is typically rendered as “appareil,” we selected “écrans” for better contextual equivalence. For item 15, to capture the intended semantic nuance of “enjoyable,” we chose “amusant.” In item 20, given the wide semantic range of “to check,” we opted for “vérifier” to best preserve the original meaning and indicate a repeated action. Finally, for item 25, “grades” was translated as “notes scolaires” to avoid ambiguity and ensure semantic clarity.

After the questionnaires were translated from the consensus version into English by the native English translator, we observed that all 21 out of 27 items of the PMUM questionnaire and all 25 items of the DASC questionnaire were accurately retranslated into English. For the PMUM questionnaire, some formulations or terms varied but did not modify the meaning of the items. One item’s semantic meaning was strongly altered during the back translation: “My child attempts to use screen media for increasing amounts of time.” was retranslated as “My child keeps using screens for longer periods.” At the semantic level, this back translation does not reflect the intention of using the screen more and more—as covered by the initial item. Consequently, we modified the French item translation to better capture the original meaning of the item.

After these modifications, 2 researchers reread the latest French translation during a final professional translation step. No suggestions or conceptual modifications were proposed for the 2 questionnaires.

The final versions of the PMUM and DASC questionnaires were delivered to adolescents and parents in the pilot study. The 8 parents had no comments for improvement for any of the items or the statements, including linguistic incomprehension, linguistic ambiguity, suggestions for modification, or redundancies.

Although some adolescents noted repetitive phrasing (redundancies) across items addressing withdrawal symptoms—for example, items 12 and 21 use “frustrated” while items 3 and 8 use “upset,” reflecting potential linguistic ambiguity—the expert team determined that these repetitions were essential for capturing subtle distinctions in behavior and experience, ensuring a comprehensive assessment of the construct, even if the phrasing occasionally feels redundant to adolescents, because “frustrated” and “upset” have close semantic meaning in French. No linguistic incomprehension was reported at this stage, and this feedback did not lead to suggestions for modification of the 25 items of the DASC questionnaire. The final translated versions are listed in Multimedia Appendix 1.

We effectively conducted a cross-cultural adaptation of 2 original questionnaires into French to measure PDU among adolescents. These questionnaires are intended to be filled out by adolescents themselves (DASC) or by their parents (PMUM). Although the DASC and PMUM questionnaires were originally validated in children aged 9‐12 and 4‐11 years, we applied these instruments to adolescents aged 12‐17 years. One of the advantages of considering these 2 questionnaires is that, given that PDU in adolescents may manifest as extreme resistance to limits imposed by parents, leading to significant intrafamilial conflicts, questioning parents in addition to adolescents provides valuable information to better understand the extent of PDU. To make these questionnaires accessible in French, we translated them from English using the forward and backward method by following the 3 stages of translation of the method recommended by Epstein et al [27] and that has already been used for prior related French translations [31]. The conceptual equivalence of the French questionnaires was close to that of the English questionnaires. Regarding our results, neither parents nor adolescents encountered major difficulties in understanding the items, and experts recognized that the final translations were equivalent to the original questionnaires. Limitations include the small sample size, although the minimum number of participants for linguistic validation is not clearly defined [28], and the lack of validation. Further studies are required to validate these translations in larger populations and confirm their psychometric properties, particularly since adolescents reported that some items of the DASC questionnaire were redundant. Although other cross-cultural adaptations studies incorporated additional steps, such as confirmatory and exploratory factor analyses, to examine the instrument’s internal structure and reliability in a simulated clinical setting [32-34], our study did not include these analyses. Yet, as the DASC questionnaire aims to assess PDU—a construct that is not directly observable and is composed of multiple dimensions such as tolerance, withdrawal symptoms, and overuse or physical and psychological consequences—future research should further investigate its structure validity. Additionally, researchers will need to assess the convergent validity of the questionnaires by showing that the scores obtained from the 2 translated questionnaires are positively correlated with other similar or closely related measures. These questionnaires can also be supplemented by objective and passive measurements derived directly from digital tools [35]. The last step will consist of evaluating the reliability of the questionnaires about their consistency and stability with longitudinal test-retest analyses.

These questionnaires, validated in French, will be useful in research to make intercultural comparisons in PDU demographics. Additionally, they can be used for professional purposes as part of medical or psychological care to detect PDU among adolescents.

This study enabled the effective cross-cultural adaptation of 2 questionnaires on the PDU of adolescents into French.

This study revealed that parents and adolescents easily understood the items, and experts confirmed the final translations’ equivalence with the originals. Once validation of the questionnaires in French is completed, these 2 questionnaires can be used in French-speaking regions to screen or measure PDU among adolescent populations. Limitations of this research include the small sample size and the lack of psychometric validation, which are necessary to establish the reliability and validity of the translated questionnaires.

This study provides a questionnaire enabling adolescents to assess their own digital addiction (DASC), and another on parents’ perceptions of their children’s use (PMUM), which will enable the research community to better detect or assess the prevalence of the PDU in the French adolescent population.