Development and Evaluation of a Digital Single-Session Reappraisal Intervention to Shift Negative Self-Focused Social Media Interpretations

Social media is fraught with ambiguity and opportunities for making skewed interpretations. For example, seeing a post of friends hanging out without you can trigger thoughts ranging from benign (“They seem to be having fun”) to negative (“They’re happy I’m not there”). 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 benign interpretations in response to ambiguity, may be protective. Interpretation bias is a modifiable treatment target in the context of both in-person therapy and digital interventions that target rigid thinking styles. Reappraisal, a cognitive skill that teaches people to respond to automatic thoughts more flexibly, may hold promise for shifting negative self-focused social media interpretations (i.e., “online” interpretation bias, which includes interpretations such as not having enough likes or followers). Through a multiphase design process with college student stakeholders, we developed a digital, single-session, self-administered reappraisal intervention to shift online interpretation bias as well as other secondary outcomes (e.g., “offline” interpretation bias; fear of missing out, known as FOMO). Feedback interviews with 20 potential end users were completed iteratively during intervention development, and the prototype was then pilot tested by 17 additional participants. The final intervention, “PRISM,” (Program for Rethinking Negative Interpretations on Social Media) includes psychoeducation related to healthy social media use, training in reappraisal, and interactive practice. A randomized-controlled trial with N = 162 college students who reported negative self-evaluations tied to social media was then conducted to compare PRISM to a control condition that also focused on social media but did not include reappraisal. Effects on online interpretation bias and secondary outcomes were assessed immediately post-intervention and at two-week follow-up. As hypothesized, PRISM led to greater reductions in online negative interpretation bias and increases in online positive interpretation bias than the control condition, both post-intervention and at two-week follow-up. Mirroring results for online interpretation bias, PRISM also led to greater (and, generally stronger) reductions in offline negative interpretation bias and increases in offline positive interpretation bias than the control condition, both post-intervention and at two-week follow-up. Though there were some significant time-by-condition effects for other secondary outcomes, they were generally weaker and unstable to sensitivity analyses. Results show that a digital, light-touch reappraisal intervention can shift online and offline interpretation biases in college students with problematic social media use.