3 - (OP31) Effects and Mechanisms of an Online Interactive Video-based CBT Intervention for Chinese Socially Anxious Adolescents

Social anxiety disorder (SAD) is one of the most common mental health conditions during adolescence. Fear of evaluation is a core feature of social anxiety and comprises fear of positive evaluation (FPE) and fear of negative evaluation (FNE). Accumulating evidence indicates that interventions targeting evaluative fears can effectively alleviate social anxiety symptoms. Cognitive Behavioural Therapy (CBT) is widely regarded as the gold-standard treatment for social anxiety; however, its dissemination and implementation remain challenging due to high time and financial costs, limited its availability of trained professionals, and the characteristic reluctance of socially anxious individuals to engage in face-to-face interventions because of concerns about being scrutinized and evaluated. Internet-based Cognitive Behavioral Therapy (ICBT) has increasingly demonstrated advantages as a self-guided intervention modality, retaining the therapeutic efficacy of traditional CBT while offering anonymity, convenience, and reduced psychological burden. Building on this framework, the present study developed an innovative online intervention centered on interactive video content grounded in core CBT components, including psychoeducation, cognitive restructuring, and exposure training. This approach aims to explore a novel mental health intervention pathway that is empirically grounded, highly scalable, and characterized by strong user adherence. The interactive videos employ branching narratives and decision-tree structures to closely simulate real-world social situations, enabling participants to engage in cognitive restructuring and exposure exercises within an immersive experience.

In this study, a total of 183 adolescents and young adults aged from 15 to 24 years with high levels of social anxiety (SPIN > 19) were recruited and then randomly assigned to either an intervention group (n=92) or a waitlist control group (n=91). The intervention group completed a four-week online interactive video program delivered via the Bilibili, a quite popular platform among Chinese adolescents, with one session per week, whereas the control group received no intervention during the same period. FPE, FNE, and social anxiety were assessed at baseline, post-intervention, and at a one-month follow-up. Compared with the control group, participants in the intervention group showed significant reductions in FPE (F = 12.964, p < .001), FNE (F = 7.068, p < .01), and overall social anxiety (F = 12.751, p < .001). Mediation analyses further revealed that reductions in fear of positive evaluation (β = −8.929, p < .001) and fear of negative evaluation (β = −8.929, p < .001) partially mediated the effects of the intervention on social anxiety.

These findings suggest that CBT-based online interactive video interventions can effectively and sustainably reduce social anxiety and evaluative fears among adolescents, providing empirical support for the dissemination of adaptive, scalable, and high-adherence digital mental health interventions.