The goal of this clinical trial is to evaluate the effectiveness of the 4-Step Training Program for Social Media Addiction (4-STEP-TPS) in reducing social media addiction, doomscrolling, cyberchondriac behavior, depressive symptoms, and health anxiety among young adults. The study aims to promote healthier digital habits, psychological well-being, and improved daily functioning. Participants with elevated social media addiction will complete a 4-week intervention with one session per week. They will be randomly assigned to either an intervention group or a waitlist control group. Pre- and post-intervention assessments will be conducted to determine the program's effectiveness.
In this research, a sample of approximately N = 300 young adults will be initially enrolled for eligibility screening from public and private universities in Faisalabad and Sahiwal, Pakistan, using purposive sampling techniques. Participants will be aged between 18 and 28 years and will have no history of severe physical, psychiatric, or psychological disorders. After eligibility assessment and screening based on standardized measures, N = 80 participants will be selected and randomly allocated to the experimental and waitlist control groups. This study is expected to provide valuable evidence for mental health practitioners regarding effective interventions for managing social media addiction among young adults. The 4-STEP Training Program is anticipated to enhance participants' awareness and understanding of problematic digital behaviors, including doomscrolling and cyberchondriac behavior. The intervention is also expected to reduce depressive symptoms and health anxiety, improve self-regulation and promote healthier digital habits. Furthermore, the program is expected to enhance psychological well-being, academic functioning, and overall productivity while significantly reducing levels of social media addiction.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
80
4 Modules with 1 Module being delivered in 1 weekly session of approximately 90 minutes. The details of each module/step is described as follows: Step 1 (Module 1): S = Screening, Assessment and Psychoeducation: Involves screening and assessment of the problem, interpretation of the results, feedback and psychoeducation, identifying and breaking the resistance, motivation, and conceptualization. Step 2 (Module 2): T = Treatment Conceptualization and Planning: Involves pattern identification, distortion identification, as well as pattern and distortions modifications. Step 3 (Module 3): E = Effective Management Strategies: Involves management strategies to treat the earlier identified patterns as well as the implementation and confirmation of activities via a Pattern Schedule Chart. Step 4 (Module 4): P = Prevention (Lapse-Relapse): Involves self-reflection and support building, monitoring and dependency check and slip plans and support additions
Government College University Faisalabad
Faisalabad, Punjab Province, Pakistan
Social Networking Addiction Scale (SNAS)
The Social Networking Addiction Scale (SNAS) was developed to measure addiction of all forms of social networking across six-dimensions salience (items 1-4), mood modification (items 5-7), tolerance (items 8-10), withdrawal (items 11-14), conflict (item 15-17), and relapse (items 18-21) (Shahnawaz \& Rehman, 2020). The SNAS is a self-reported scale which entails 21-items scale rated on 7-point Likert scale ranging from 1 (strongly disagree) to 7 (strongly agree). The score can range from 21 to 147. Any score above a total score of 84 signifies addiction. The scale has demonstrated good test-retest reliability of 0.88 and good validity as reported by Shahnawaz and Rehman (2020).
Time frame: At screening, after 4 weeks, and reassessment up to 6 months
Cyberchondria Severity Scale (CSS-12)
The Cyberchondria Severity Scale-12 (CSS-12), developed by Eoin McElroy et al. (2019), is a 12-item self-report measure assessing excessive, anxiety-provoking online health searches across four dimensions: compulsion, distress, excessiveness, and reassurance-seeking. Items are rated on a 5-point Likert scale (1 = Never to 5 = Always), with total scores ranging from 12-60; higher scores indicate greater cyberchondria. The scale is brief, reliable, and valid, suitable for both clinical and non-clinical populations, and widely used to evaluate problematic health-related online behavior.
Time frame: At screening, after 4 weeks, and reassessment up to 6 months
Doomscrolling Scale (DS)
The Doomscrolling Scale was developed to assess compulsive engagement with negative online news content and excessive scrolling behavior, particularly during times of crisis (Sharma et al., 2022). The scale measures three core dimensions: obsessive news consumption, emotional distress, and behavioral compulsion. It is a self-report instrument consisting of 15 items rated on a 5-point Likert scale ranging from 1 (never) to 5 (always). The total score is calculated by summing all item responses, with higher scores indicating greater levels of doomscrolling behavior. The scale has demonstrated good internal consistency (Cronbach's α = 0.88) and satisfactory construct validity (Sharma et al., 2022).
Time frame: At screening, after 4 weeks, and reassessment up to 6 months
Short Health Anxiety Inventory (SHAI)
The Short Health Anxiety Inventory (SHAI) was developed to assess health-related anxiety and preoccupation with physical symptoms, independent of actual medical status (Salkovskis et al., 2002). The scale measures two main dimensions: perceived likelihood of illness and perceived negative consequences of illness. It is a self-report instrument consisting of 18 items, each presenting four response options scored from 0 to 3, reflecting increasing levels of health anxiety. Total scores range from 0 to 54, with higher scores indicating greater levels of health anxiety. The SHAI has demonstrated excellent internal consistency, with reported Cronbach's alpha values ranging from 0.86 to 0.95, and strong convergent and construct validity. The HAI is a reliable and valid measure of health anxiety (Salkovskis et al., 2002).
Time frame: At screening, after 4 weeks, and reassessment up to 6 months
Patient Health Questionnaire-9 (PHQ-9)
The Patient Health Questionnaire-9 (PHQ-9) was developed to measure the severity of depressive symptoms based on the diagnostic criteria of major depressive disorder (Kroenke et al., 2001). The scale assesses nine core symptoms of depression, including low mood, loss of interest, fatigue, sleep disturbances, appetite changes, concentration difficulties, feelings of worthlessness, psychomotor changes, and suicidal ideation. The PHQ-9 is a self-report instrument consisting of 9 items rated on a 4-point Likert scale ranging from 0 (not at all) to 3 (nearly every day). Total scores range from 0 to 27, with higher scores indicating greater severity of depressive symptoms. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders(The PHQ-9 - Kroenke - 2001 - Journal of General Internal Medicine - Wiley Online Library, 2001).
Time frame: At screening, after 4 weeks, and reassessment up to 6 months
Atika Shafi, MS Clinical Psychology
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