Baseline emotional distress predicts psychological response to a social media reduction intervention in distressed youth: a precision mental health approach.

Abstract

Reducing social media use (SMU) leads to small reductions in anxiety and depressive symptoms. However, most studies have been conducted with healthy populations, which may limit observed effects due to floor effects rather than indicating a weak causal link. Youth with elevated anxiety and depression symptoms may be more vulnerable to social media harms and benefit more from reduction, but experimental evidence remains limited for symptomatic samples. The present study examined whether youth with elevated symptoms of anxiety and depression show greater psychological benefits from reducing SMU compared to those with sub-threshold symptoms. A total of 218 out of 260 participants who were randomized to an intervention (reduce SMU to 1 h/day) or control group (no SMU restriction) for three weeks were analysed. Depressive and anxiety symptoms were assessed using CES-D and GAD-7 scales, respectively. At baseline, 75% and 46% of the sample scored above the clinical thresholds for elevated depressive and anxiety symptoms, respectively. Mixed models indicated that baseline anxiety levels moderated the intervention response. Participants above the clinical threshold exhibited significantly greater and clinically meaningful reduction in anxiety symptoms relative to controls compared to those below the threshold. Baseline depressive symptoms severity did not moderate intervention response. Results underscore the strong causal relationship between SMU and anxiety symptoms and suggest that reducing SMU may represent a potential component in the management of anxiety disorders in youth. The intervention reduced depressive symptoms overall, but findings on baseline symptom severity as a moderator of response were inconclusive and require replication.