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.
Age range: 18-29 years
No physical, psychiatric, or psychological conditions
Minimum score of 84 on the Social Networking Addiction Scale (SNAS)
Minimum score of 23 on the Cyberchondria Severity Scale (CSS-12)
Age below 18 or above 29 years
Presence of any physical, psychiatric, or psychological conditions
Score below 84 on the Social Networking Addiction Scale (SNAS)
Score below 23 on the Cyberchondria Severity Scale (CSS-12)
Parallel
4-STEP-Training Program for Social Media Addiction (4-STEP-TPS)
Behavioral4 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
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).
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.
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).
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).
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