Cognitive Diagnosis Computerized Adaptive Testing (CD-CAT) for Adolescent Internet Gaming Disorder: A Conceptual Assessment Framework

Internet Gaming Disorder (IGD) has become a major behavioral health concern among adolescents, yet current assessment tools remain limited. These tools often fail to capture the disorder’s complex symptom variations and lack clinical interpretability. This study, taking an interdisciplinary approach that combines clinical psychology and psychometrics, summarizes recent progress in understanding adolescent IGD and the development of its assessment methods. We compare the diagnostic criteria of the DSM-5 TR and ICD-11 and argue that the nine DSM-5 TR criteria are particularly suited for transformation into distinct diagnostic attributes due to their detailed and actionable nature. We then review the strengths and weaknesses of Classical Test Theory (CTT), Item Response Theory (IRT), and Cognitive Diagnostic Models (CDMs) in assessing IGD. The review emphasizes the limitations of total-score and single latent-trait approaches in capturing the disorder’s multidimensional symptoms. Based on these insights, we propose a conceptual assessment framework, Cognitive Diagnosis Computerized Adaptive Testing (CD-CAT), that integrates CDMs with computerized adaptive testing. Rather than presenting an empirically validated system, this framework offers a theoretically grounded proposal that specifies the key components, logical relationships, and methodological pathways necessary for advancing precision assessment of adolescent IGD. CD-CAT uses a system of attributes and a Q-matrix based on the DSM-5 TR criteria to efficiently classify IGD symptoms in adolescents, reducing the number of items required while enhancing clinical relevance. Lastly, we discuss the theoretical contributions of the proposed framework, acknowledge its limitations as a conceptual proposal, and outline directions for future empirical research.