(PS8-86) Self-guided digital interventions for adolescent and young adult body image concerns: A state-of-the-science review

Body dissatisfaction is a significant risk factor for depression, anxiety, eating disorders, and body dysmorphic disorder. Body image concerns affect individuals across race, gender, and age, with adolescence being a critical period for the onset of body dissatisfaction. Despite the availability of empirically supported interventions such as cognitive-behavioral therapy (CBT), access remains limited due to cost, stigma, and logistical barriers. Self-guided digital mental health interventions (DMHIs) offer a scalable and accessible alternative and are perceived as acceptable and feasible by adolescents. However, no systematic reviews to date have examined the efficacy of self-guided DMHIs for body image concerns in mixed-gender samples of adolescents and young adults. We describe intervention characteristics and identify research gaps in self-guided DMHIs for body image concerns in adolescents and young adults.

In January 2024, a literature search was conducted in Embase, PsycINFO, and PubMed to identify DMHIs targeting body image concerns in adolescents and young adults ages 13-21. Articles were included if they described a self-guided DMHI, targeted body image or a related concept (e.g., body dissatisfaction) and included a body image-related outcome measure. Nine studies meeting these criteria were included for data extraction. Information about study design, participant and intervention characteristics, and results were extracted.

The included studies were published between 2013 and 2023, with 44.44% (n = 4) published in the past five years. The mean age of participants was 17.71 years (range = 15.30–20.85), and 66.66% (n = 6) included female-only samples. Nearly half of the studies (44.44%; n = 4) did not include follow-up assessments, and no studies followed participants beyond six months. Internet-based interventions were the most common (n = 3), whereas podcast-based interventions were the least common (n = 1). The studies were grounded in a range of theoretical models, with dissonance-based interventions (DBI; n = 3) and the Tripartite Influence Model of Body Image (n = 2) being the most common. Other approaches (n = 1 each) included CBT, social cognitive theory, sociocultural theory, compassionate mind training, mindfulness, and evaluative conditioning.

Findings highlight the potential of self-guided DMHIs to improve body image among adolescents and young adults, though efficacy varied due to significant methodological differences across studies. Future studies should (i) develop inclusive interventions that address gender diversity, (ii) increase engagement through gamification and personalization, (iii) integrate well-established and evidence-based therapeutic frameworks (e.g., CBT) and (iv) extend follow-up periods to assess the long-term sustainability of intervention effects. Addressing these gaps could strengthen the evidence base for body image-focused DMHIs and maximize their effectiveness for diverse adolescent and young adult populations.