Development and evaluation of a digital single-session reappraisal intervention to shift negative self-focused social...

Social media is fraught with ambiguity and opportunities for making skewed interpretations. Negative interpretation bias, or the tendency to assign negative meanings in response to ambiguous information, is associated with mental health problems like depression and anxiety, while positive interpretation bias, or the tendency to make positive interpretations in response to ambiguity, may be protective. Interpretation bias is a modifiable treatment target in cognitive interventions. Reappraisal, which involves considering different perspectives, may hold promise for shifting negative self-focused social media interpretations (i.e., "online" interpretation bias, such as catastrophic thoughts about the significance of not having enough likes or followers). Through a multiphase user-centered design process with college student stakeholders (N = 37), we developed a digital single-session reappraisal intervention to shift online interpretation bias, as well as secondary outcomes (e.g., "offline" interpretation bias, reflecting interpretations about situations that are not online, like in-person parties). A randomized-controlled trial with N = 162 college students who reported negative self-evaluations tied to social media was conducted to compare PRISM to an activity-matched social media control condition. As hypothesized, PRISM led to greater reductions in online and offline negative interpretation bias and increases in online and offline positive interpretation bias than the control condition, post-intervention and at two-week follow-up. However, PRISM was largely ineffective in shifting outcomes other than interpretation bias (e.g., anxiety and depressive symptoms), underscoring the need to enhance transfer of the interpretation bias changes to improve other clinical outcomes.