Sebastian Brand

Background: Image- and video-based social media have been linked to body dissatisfaction and eating pathology, partly through increased appearance-based social comparison and self-focused attention. The Social Media Appearance Preoccupation Scale (SMAPS) assesses three behaviors relevant in this context: Online Self-Presentation, Appearance-Related Activity, and Appearance Comparison. Higher scores on these dimensions have been linked to more intensive social media use, increased anxiety, depressive symptoms, and disordered eating. However, research has largely relied on English-speaking, non-clinical samples. The present studies therefore aimed to translate and validate a German version of the SMAPS and to compare appearance-related social media behaviors between individuals with eating disorders and healthy controls. Methods: The scale was translated in a systematic translation-back-translation procedure and then examined in two cross-sectional studies. In Study 1, N = 363 young adults completed a survey with the aim of testing the factor structure of the German SMAPS and its associations with eating disorder pathology, general psychological distress, and problematic internet use. In Study 2, multivariate analysis of variance was used to compare German SMAPS scores between n = 21 outpatients with diagnosed eating disorders and n = 37 healthy controls. Results: The three-factor structure of the German SMAPS showed acceptable model fit. All subscales exhibited good internal consistency (ω = 0.83-0.88). Of the three dimensions, Appearance Comparison was most strongly associated with eating disorder pathology and showed the most consistent associations with psychological distress and problematic internet use. It also significantly differentiated patients with eating disorders from healthy controls ( p = .004, η² _p = 0.14, 90% CI [0.03, 0.29]). Conclusions: The German SMAPS is a reliable and valid tool for assessing appearance-related social media behaviors in German-speaking populations. The findings suggest that the three dimensions may differ in clinical relevance, with appearance comparison warranting particular attention in future research.

Aims: This pilot study aimed to investigate the feasibility and initial efficacy of a smartphone-based approach-avoidance task (AAT)-training in reducing problematic internet use among adolescents and young adults. The intervention targets automatic action tendencies (approach biases) toward internet-related cues to reduce maladaptive usage patterns. Methodology: In a randomized controlled pilot trial with a waitlist control group, 24 participants with elevated levels of problematic internet use (aged 12–31 years) were included. Participants in the intervention group engaged in a 21-day AAT training via the PROTECTapp, while the control group was placed on a waitlist. The primary outcome was the severity of problematic internet use measured by the Compulsive Internet Use Scale (CIUS). Secondary outcomes included symptoms of specific online behavioral addictions (i.e., problematic social media use and problematic gaming) and psychological well-being. Results: The intervention group showed a significant reduction in problematic internet use compared to the control group, with a large between-group effect size ( d = -0.98). A higher proportion of participants in the intervention group achieved reliable improvement on the CIUS. No significant effects were observed for secondary outcomes, including gaming, social media use, or psychological well-being. Conclusions: The results support the feasibility and preliminary efficacy of a smartphone-based AAT training in reducing problematic internet use. The findings suggest that AAT-based interventions may represent a promising, low-threshold component within blended treatment approaches for problematic internet use. Further research in larger, stratified samples and with extended follow-up periods is warranted.

Background and aims: Problematic usage of the internet (PUI) has been linked to impaired mental health and academic functioning in young adults. This randomized controlled trial evaluated the efficacy of a 3-week mobile-based approach–avoidance task (AAT) training (PROTECTapp) for reducing PUI in university students. Methods: Ninety-two participants ( M _age = 22.00 years, 69.6% women) with elevated levels of PUI were randomized to the PROTECTapp intervention ( n = 45) or a waitlist control group ( n = 47). Primary outcomes were PUI severity and internet-related craving. Secondary outcomes included motivation to change, psychopathological symptoms and academic functioning. Participants were assessed at baseline and postintervention; the intervention group completed additional 3- and 12-week follow-ups. Results: Intention-to-treat analyses indicated greater reductions in PUI following the PROTECTapp intervention compared to the waitlist ( p = .003; d = −0.80, 95% CI [−1.23, −0.38]). No significant effects emerged for craving or broader psychological outcomes ( p s > .05), though favorable effects were observed on motivation to change (ambivalence: p = .020; d = −0.24, 95% CI [−0.65, 0.17]; taking steps: p = .002; d = 0.45 [0.04, 0.87]). Satisfaction with the intervention was moderate ( M = 18.32 of 32), and participants completed on average 35.52 training sessions. Adverse events were reported infrequent (7.1%). Discussion and Conclusions: PROTECTapp is a promising mobile-based intervention to reduce PUI and enhance motivation to change in young adults. Its brevity, scalability, and safety profile highlight its potential as a low-threshold preventive or adjunctive intervention for young individuals at-risk.

Accurate screening for Internet Gaming Disorder (IGD) in children and adolescents remains a challenge in routine clinical settings. This study evaluated the psychometric properties and diagnostic utility of the Inclusion of Videogame in the Self (IVS) scale, a brief pictorial tool assessing the perceived fusion between self and video game. A clinical sample of 189 children and adolescents ( M = 13.0 years, SD = 3.2) completed the IVS, IGD, and Social Media Disorder (SMD) measures. While the five-item scale showed a solid factor structure and reliability, diagnostic accuracy was limited. A single item assessing the “relationship” with the favorite game emerged as a strong screening proxy, correlating with IGD and minimally with SMD. A cutoff score of 3 or higher yielded 100% sensitivity and a 45% false-positive rate. The Single-Item IVS shows promise as a quick, developmentally appropriate screening tool to identify youth at risk for IGD, warranting further validation in broader samples. More generally, the IVS represents the first attempt to conceptualize inclusion of self with an object or activity (i.e., favorite game) rather than with a group or another person.

Objective: Problematic usage of the internet (PUI) has been linked to impaired mental health and academic functioning in young adults. This randomized controlled trial evaluated the efficacy of a 3-week mobile-based approach–avoidance task (AAT) training (PROTECTapp) for reducing PUI in university students. Method: Ninety-two participants (Mage = 22.00 years, 69.6% female) with elevated levels of PUI were randomized to the PROTECTapp intervention (n = 45) or a waitlist control group (n = 47). Primary outcomes were PUI severity and internet-related craving. Secondary outcomes included motivation to change, psychopathological symptoms and academic functioning. Participants were assessed at baseline and postintervention; the intervention group completed additional 3- and 12-week follow-ups. Results: Intention-to-treat analyses indicated greater reductions in PUI following the PROTECTapp intervention compared to the waitlist (p = .003; d = -0.80, 95% CI [-1.23, -0.38]). No significant effects emerged for craving or broader psychological outcomes (ps < .05), though favorable effects were observed on motivation to change (ambivalence: p = .020; d = -0.24, 95% CI [-0.65, 0.17]; taking steps: p = .002; d = 0.45, [0.04, 0.87]). Satisfaction with the intervention was moderate (M = 18.32 of 32), and participants completed on average 35.52 training sessions. Adverse events were reported infrequent (7.1%). Conclusion: PROTECTapp is a promising mobile-based intervention to reduce PUI and enhance motivation to change in young adults. Its brevity, scalability, and safety profile highlight its potential as a low-threshold preventive or adjunctive intervention for young individuals at-risk.

Objective: Somatic symptoms are highly prevalent in youth, but the treatment effectiveness for somatic symptom disorder is limited and the underlying mechanisms are incompletely understood. According to a predictive coding approach, low interoceptive accuracy (i.e., accuracy in perceiving internal signals from the body) may relate to somatic symptoms. So far, a potential moderating effect of personality factors on this relationship has been unexplored. Neuroticism and perfectionism could play a major role in this moderation in that they could shape expectations to be more pessimistic. This study examines the connection of neuroticism and perfectionism with interoception as well as with somatic symptoms in adolescents. Method: 172 adolescents (aged 14–21) completed psychometric questionnaires assessing interoceptive accuracy, somatic symptoms, as well as levels of neuroticism and perfectionism in a cross-sectional survey. Results: Increased neuroticism was associated with reduced interoceptive accuracy ( r = –.25, p = .003), whereas the relationship between perfectionism and interoceptive accuracy did not reach significance ( r = –.17, p = .053). Furthermore, neuroticism and perfectionism were each associated with more somatic symptoms ( r = .39, p < .001; r = .23, p = .006). Neither neuroticism nor perfectionism moderated the relationship between interoceptive accuracy and somatic symptoms (Δ R ² = 0.06%, p = .794; Δ R ² = 0.92%, p = .510). Conclusion: We discuss the results in the context of a predictive processing approach for the development of somatic symptoms and the need for further research.

The MAIA-Y (Jones et al., 2021) is a 32-item self-report measure to assess interoceptive awareness in eight dimensions: Noticing, Not-Distracting, Not-Worrying, Attention Regulation, Emotional Awareness, Self-Regulation, Body-Listening and Trusting. These scales are considered to be related but separate aspects of interoceptive awareness (Mehling et al., 2012). Higher scores indicate better interoceptive ability.

Objective: Problematic usage of the internet (PUI) is a growing concern in young adults. Mobile-based approach bias modification (ApBM) has proven efficacious; however, individual differences in intervention response remain poorly understood. This exploratory analysis examined baseline participant characteristics as potential moderators and predictors of outcome following mobile-based ApBM (PROTECTapp) to reduce PUI in university students. Methods: Based on data of 92 university students (Mage = 22.00 years, 69.6% female) with elevated PUI who were randomized to PROTECTapp (n = 45) or a waitlist control group (n = 47), we examined age, baseline PUI severity, motivation to change, comorbid internalizing symptoms, procrastination, and positive intervention expectancies as potential moderators and predictors of PUI (Compulsive Internet Use Scale, CIUS) and adherence at post-intervention. Results: Baseline PUI severity significantly moderated intervention efficacy (b = -0.42, SE = 0.20, p = .040), indicating stronger effects among individuals with higher initial symptom severity. No significant moderating effects emerged for other potential moderators. In a combined cross-over sample, higher baseline PUI severity (aOR = 1.37, p < .001) and younger age (aOR = 0.67, p = .011) predicted greater likelihood of reliable improvement, while adherence was higher in younger participants (b = -2.43, SE = 1.01, p = .019) and those with higher internalizing symptoms (b = 2.68, SE = 1.24, p = .033). Conclusion: Mobile-based ApBM appears particularly effective for young adults with more severe PUI, supporting targeted rather than universal prevention approaches. Other baseline factors did not influence efficacy, underscoring broad applicability across diverse student populations.

Theoretical Background: Interoceptive accuracy and emotion regulation are interrelated processes that play a crucial role in mental health. However, their interaction during childhood and adolescence remains under-researched, and there are no validated German-language self-report instruments for assessing interoceptive accuracy at these developmental stages. Objective: The study investigated the relationship between interoceptive accuracy, emotion regulation, and symptoms of psychopathology in children and adolescents. Specifically, we aimed to evaluate the psychometric properties of a child-adapted version of the Interoceptive Accuracy Scale (IAS). We hypothesize that self-reported interoceptive accuracy is negatively correlated with symptoms of psychopathology, and that emotion regulation mediates the relationship between interoceptive accuracy and psychopathological symptoms. Method: Two separate cross-sectional online studies were conducted with a total of 131 children and adolescents ( N₁ = 65, N₂ = 66) aged 8 – 17 years ( M = 11.8, SD = 2.3) and their parents. Participants provided self-reports on interoceptive accuracy and psychopathological symptoms, while both self and parent assessments were utilized to evaluate emotion regulation strategies. Results: The adapted IAS-C demonstrated high internal consistency (ω = .87). IAS-C scores were negatively associated with maladaptive emotion regulation strategies as well as internalizing, externalizing, and somatoform symptoms. Mediation analysis revealed that self-reported maladaptive emotion regulation mediated the relationship between self-reported interoceptive accuracy and symptoms of psychopathology; however, no such mediation effect was observed for parent-reported emotion regulation. Discussion and Conclusion: The German version of the IAS-C appears to be a suitable and valuable instrument for assessing self-reported interoceptive accuracy in children and adolescents. The findings highlight the relationship between interoceptive accuracy, emotion regulation, and symptoms of psychopathology in youth.