Picture This: Learning to Focus and Savor With a Smartphone
Phase: NA
Conditions: College Student Mental Health, Mindfulness, Positive Emotions, Savoring, Intervention Study
Sponsor: Georgia State University

TITLE: Picture This: Learning to Focus and Savor With a Smartphone   
NCT: Not yet assigned 
DATE: 12/5/25 

PICTURE THIS STUDY PROTOCOL 
 
The proposed intervention draws primarily from two paradigms, positive psychology interventions (PPI) and 
cognitive bias modification (CBI), and marries components of each into a technology-enhanced program designed 
to increase global well-being and decrease social isolation and depressive symptoms among college students. 
Although both intervention paradigms are in relatively early stages of investigation, they have garnered an 
impressive amount of empirical support indicating their success with regard to increasing psychological health.  
While they have grown out of very different traditions and theoretical cloths, both approaches also aim to uplift 
individuals who are languishing rather than flourishing and provide behavioral, cognitive, and attentional tools to 
increase the experience of positive emotion.  
 
Although they come in various forms ranging from the intentional practice of positive thinking to writing letters of 
gratitude and increasing social interactions, all positive psychology interventions (PPIs) utilize practices, tools, and 
exercises to cultivate or increase the participant’s sense of subjective well-being. They are, by definition, strengths-
based and so do not necessarily intend to address deficits or heal pathology; rather, they are designed to optimize, 
to build, and to elevate. Recently, PPIs have been utilized with participants suffering from depression. While this 
application may at first blush seem at odds with the definition, a closer look provides clarity. Depression is 
characterized not only by high levels of negative affect but also low levels of positive affect. Research to date 
indicates that increased positive emotion in depressed individuals is beneficial with regard to “increased broad-
minded coping,” (Joiner & Frederickson, 2002), resilience from negative emotions (Tugade & Fredrickson, 2004), 
and even in preventing relapse (Fava & Ruini, 2003). Accordingly, such interventions are a natural fit for 
depression.  A recent meta-analysis suggests that PPIs are superior to control or comparison groups in enhancing 
well being and in addressing depressive symptoms; however, PPIs may be relatively more successful for depressed 
participants and participants who self-select into the interventions (Sin & Lybomirsky, 2009).  
 
Cognitive models of depression have long posited that individuals suffering from affective disorders (namely, 
Major Depressive Disorder) show information processing deficits that include increased attention to negatively-
valenced cues.  For example, when presented with both sad and neutral faces, subjects diagnosed with MDD 
selectively attended to the sad face, whereas control subjects divided attention between the sad and neutral faces 
(Gotlib et al., 2004). More recent work indicates that dysphoric individuals lack a protective bias toward positive 
stimuli (Ellis et al., 2011) and that they have difficulty disengaging from “mood-congruent (i.e., sad, negative)” 
stimuli (Bradley et al., 1997; Mathews & MacLeod, 2005). There is also some evidence that depressed individuals 
may be more likely to interpret ambiguous stimuli as threatening.  Recently, researchers have tested cognitive bias 
modification interventions (CBI), which are designed explicitly to modify dysfunctional patterns of information 
processing including both attentional and interpretation biases. In their meta-analysis of 45 CBM studies, Hallon & 
Ruscio (2011) found, overall, a medium effect size for the CBMs on cognitive biases and a small, but significant, 
effect on anxiety and depressive symptoms before the data was corrected for publication bias. Although the 
effects were no longer significant after correction for publication bias, the authors report a larger and more robust 
(while still insignificant) effect for CBMs when measured in the context of a stressor, giving credence to the 
diathesis-stress cognitive paradigm.  They also noted that interpretational biases were impacted relatively more 
than attentional biases by the intervention manipulation, and anxiety symptoms relatively more than depressive 
symptoms.  
 
Building upon these two disparate bodies of research, the current project aims aim to test a set of exercises using 
Smartphones with college and graduate students designed to retrain attention toward moments/events/people 
that elicit positive emotions, encourage the savoring of such moments, increase social connectedness, and in turn, 
decrease depressive symptoms. The aims will be achieved by recruiting college/university/graduate students who 
provide consent to participate in a randomized trial of the intervention and who will be randomly be assigned to 1 
of 4 conditions.  
1) Those participants who are randomized to the active Picture This! savoring condition will be asked to 
use their Smartphones to take at least two photographs each day for 3 weeks of something that 
brings them joy or peace and to upload their pictures daily to a drive accessed by study staff 
(instructions for each condition may be found in Appendix A). Each evening, they will be directed to 

complete an online exercise in which they review the photograph(s) taken that day. They are also 
asked to complete several questions via an internet survey.  
2) Participants randomized to the Picture This! Plus Social Sharing will do everything as described for the 
Picture This! group. In addition, each week, they will be directed to share the photos they took during 
the prior week with a friend or family member (see script provided in Appendix B).   
3) Those participants who are randomized to the active control condition (Document This!) will also be 
asked to take 2 photographs each day using a Smartphone and to upload their pictures daily to a 
drive accessed by study staff. Rather than focusing on and capturing a photo of stimuli that evokes 
positive emotion, however, they will be directed to take pictures of things in their lives or 
surroundings that are representative of a “day in the life”. Like the participants in the Picture This! 
and Picture This! Plus Social Sharing Groups, they will also be asked to complete an online exercise 
each evening in which they review their documentary photos each evening and also asked to 
complete a series of questions via an internet survey.  
4) Finally, participants randomized to the passive control group will NOT be directed to take any pictures 
during the 3 week intervention period.  
All research participants in all 4 groups will be asked to complete a weekly online survey asking about whether 
they shared the pictures they took as a part of the study or as a part of their regular life (see Appendix F). 
 
At the end of the intervention, all subjects will be provided a list of local mental health resources and will also be 
provided with the instructions for all 3 picture taking conditions (should they wish to implement any of the other 
exercises on their own time). 
  
2.   Identification of Subjects: 
 
Subjects must freely volunteer to participate. No coercion, implicit or otherwise, is permitted. Describe how 
potential subjects will be identified and approached (e.g., in class, door to door solicitation, through an ad, 
etc.). If the contact will be made in person, provide the statement that will be made orally to the potential 
subject(s). If the contact will be made in writing, submit a copy of the written communication text with this 
application.  
 
Approximately 240 potential participants will be recruited at Clark University and at other universities in the larger 
Worcester community via flyering around campus as well as around Worcester in off campus public locations, 
email announcements, in-class announcements, electronic advertisement boards and via the Clark psychology 
subject pool. We would also like to post the contents of the flyers on a Facebook page created for the LEAF lab as 
well as Prof. McKee’s website hosted by Clark. In order to extend recruitment beyond Clark, we will attempt to 
contact officials at other local universities to determine whether they will allow recruitment on their campuses 
and will follow their guidelines regarding local IRB approval, posting flyers on campus, email blasts, postings on 
electronic advertisement boards. Upon approval on other campuses, we would use all of the aforementioned 
resources (flyers on campus, emails, etc.) as appropriate. 
 
Interested students will be screened for eligibility either in person or over the phone (See Appendix C). If eligible, 
they will be schedule for an appointment, consented, asked to complete a series of questionnaires and 2 computer 
tasks, and then randomly assigned to 1 of 4 groups.   
 
There is no deceit involved in the study.  
 
 
3.  Testing Procedure: 
 
Outline the testing procedure in sufficient detail to permit the Committee's assessment of potential 
psychological or physical implications (e.g. length of experiment, possible deception, physical or 
psychological discomfort). Attach a copy of any questionnaire or written test to be used in the study. For 
interviews, provide a copy of the interview questions to be used.  Some research may be exempted, upon 

review, from the IRB. A list of possible exempted research is available on this web page link.  If you state 
that "minimal risk" may occur, please explain why (i.e. subject matter covered, the way responses are 
gathered, etc.) 
 
Participants in all 4 groups who provide informed consent will be asked to complete a contact information sheet 
(in which they will be asked to provide name, telephone number, address and email address) and a baseline 
assessment packet that includes the following measures (see Baseline Questionnaire Packet for actual measures). 
Given the length of the questionnaire packets at baseline and follow-up, participants will be asked to stop and take 
a 5-minute break after approximately 25-30 minutes to reduce fatigue and increase the likelihood of gathering 
quality data. Participants will also be asked to complete a computerized attentional bias task, in which they are 
shown a series of neutral and sad or neutral and happy faces for a brief duration (e.g., 500-1000ms). The images 
are removed and one image is replaced with either an O or Q. The participant is asked to indicate on a response 
box which letter replaced the image. This task is a test to determine whether the subject has a negative attentional 
bias. They will also asked to complete a second computer task in which they are shown a series of faces, starting 
from neutral, that eventually morph into happy, angry, or sad faces. Participants are asked to indicate (by pressing 
a key or response box) when they can identify the emotion and then are asked to identify the emotion. 
1) Demographics and psychiatric history measure created for this study and includes information about sex, 
age, relationship status, income, and individual and family current and past psychiatric diagnostic status. 
2) Modified Differential Emotion Scale (MDES) is a scale that includes 20 different positive and negative 
emotional states. Respondents are asked to indicate how often in the past month they have experienced 
each emotion. 
3) Self-Other Four Immeasurables Scale is a 16 item scale designed to measure kindness, compassion, joy, 
and acceptance toward self and others. Respondents use a 5 point Likert scale to indicate how often 
they have experienced the thoughts, emotions, and behaviors in the past week. 
4) Ambiguous Situation task consists of 10 statements that can be interpreted in either a positive/neutral or 
negative light.  After reading each statement, the participant is asked to rank order 4 potential 
interpretations of the scenario they’ve just read in terms of how closely they resemble the scenario. 
5) Santa Clara Brief Compassion Scale is a 5 item version of the Sprecher and Fehr Compassionate Love 
Scale. Respondents use a 7 point Likert scale to indicate how well the statement applies to them. An 
example item is “I tend to feel compassion for people, even though I do not know them.” 
6) Gratitude Questionnaire (GQ-6) consists of 6 statements regarding gratitude and thankfulness to which 
respondents are to indicate, using a 7 point Likert scale, how well the statement applies to them. 
7) Cognitive Style Questionnaire Short Form (CSSF) requests that participants respond to 8 hypothetical 
negative and positive situations in order to assess the 3 components of hopelessness theory (i.e., 
stability, global of the negative event, likelihood of negative consequences of the event, and the events’ 
negative implications for the self worth of the individual). 
8) The Beck Depression Inventory-II (BDI-II) is a 21 item self report measure of depressive symptoms in 
which participants indicate the degree to which they have experienced each symptom in the past 2 
weeks. The question about suicide has been deleted from the questionnaire.  
9) State-Trait Anxiety Inventory (STAI) consists of 20 statements describing positive and negative emotional 
and physical states. Individuals are asked to indicate how often each statement generally describes how 
they feel. (Note: Although a copy of the STAI is included in the Baseline and Follow-up Assessment 
questionnaire packets for your review, it will be purchased from Mindgarden.) 
10) Savoring Beliefs Inventory (SBI) is a 24 item measure on which participants are asked to indicated how 
strongly they agree or disagree with statements about reminiscing about happy times and anticipating 
happy times.  
11) Carolina Empirically Derived Mindfulness Inventory (CEMDI) includes 22 items that assess several facets 
of mindfulness (i.e., Observe, Non-judgment) and emotion regulation (i.e., Acceptance) Participants 
indicate on a 5 point scale how often each item is true (anchors: never or very rarely to very often or 
always).  
12) Brief Satisfaction with Life Scale (BSWLS) consists of 5 statements describing global satisfaction with their 
current life conditions. Using a 7 point Likert scale, respondents are asked to indicate how strongly they 
agree or disagree with each statement. 

13) Rosenberg Self Esteem (RSE) is composed of 10 statements regarding general notions of self perception. 
The respondent is directed to indicate how strongly he/she agrees with the statement (i.e., I take a 
positive attitude toward myself) using a 7 point Likert scale. 
14) Scale of Physical Symptoms consists of a list of 9 physical symptoms including shortness of breath, 
runny or congested nose, and chest or heart pain. Participants indicate how often they’ve experienced 
such symptoms over the past month using a 7 point scale, ranging from Not at All to Frequently.  
15) Pittsburgh Sleep Quality Inventory (PSQI) is a self report measure designed to assess sleep difficulties, 
sleep quality, and to gather data regarding bedtimes, waking times, and number of hours slept. 
16) Social Connectedness Scale (SCS) is an 8 item scale that assesses an individual’s sense of connection and 
disconnection to society, peers, etc. Two additional items have been added to the original scale to 
assess connection/disconnection to nature and to a spiritual/religious community. 
17) MOS Social Support Scale is composed of 19 statements describing possible supports (e.g., advice, 
information, help with chores) to which the respondent is asked to indicate how often each is available to 
him/her. 
18) Perceived Stress Scale (PSS) asks respondents to indicate how often in the past month they have felt 
stressed, nervous, unable to cope, etc., using a 5 point Likert scale.  
19) Life Events Scale (LES) requires individuals to indicate which of the possible positive negative life events 
he/she has experienced during the most recent 6 months.  
20) Emotion Socialization Scale of the Emotions as Child Scale (EAC) was modified slightly by Garside and 
colleagues to include both mother and father responses to the respondent’s emotional displays as a child.  
Using a 7 point Likert scale, participants indicate how often each parent responded to sadness, for 
example, with 15 different possibilities.   
21) Emotion Regulation Questionnaire (ERQ) directs participants to indicate how strongly they agree or 
disagree with 10 statements describing ways people typically regulate or manage emotion.  
22) Ten Item Personality Inventory (TIPI) is a very brief measure of personality. Participants are asked to 
indicate the extent to which each of the statements describes them.  
23) Test of Self Conscious Affect – 3 (TOSCA-3) is a scenario based measure composed of 16 scenarios of 
potential positive and negative occurrences in work and social arenas of life. It is designed primarily to 
assess shame and guilt responses but also includes pride. The respondent is asked to respond to several 
questions following the scenarios indicating the likelihood of reacting in certain ways. Sixteen of the 32 
scenarios are presented at baseline. 
24) Irritability Question – One question designed to assess participant irritability at the conclusion of 
completing the questionnaires was added. 
 
Following completion of the questionnaire packet and the computerized tasks, the participant will be randomized 
to 1 of 4 groups. All groups will be provided a packet of instructions to guide their participation in the coming 
weeks, and the packet will be reviewed with the participant by someone on the research team (see Appendix A). 
Participants in the 3 picture taking groups will also be provided instructions to create a login to the research drive 
if they do not have an account and will be provided instructions regarding how to upload their photographs to the 
research drive. 
 
In brief, both the Picture This! and the Picture This! Plus Social Sharing groups groups will be asked to utilize their 
Smartphones to take photographs on a daily basis for 21 days. The participants in the Picture This! and Picture 
This! Plus Social Sharing Group are asked to notice and then photograph events/situations/people/places/cues 
that elicit positive emotion (i.e., joy, awe, gratitude). They are asked to take at least two photographs each day. 
Participants in the active Document This! control group are also asked to take at least two photographs each day 
for 21 days that they feel is a good representation of their daily lives. The passive control group is not asked to take 
any pictures over the 21 day period.  Each day, participants in the active conditions are asked to upload the 
photographs taken that day to a Google Drive accessed only by study staff. Participants will not have access to 
other participants’ photographs, only their own. Participants will be informed in the consent form that submission 
of photographs poses a risk to confidentiality because the photos may include “self-shots” (photos they have taken 
of themselves) or photos of other things that could be linked back to them personally if by chance the trained and 
ethically-bound research assistants happen to know the participants. 

 
At the conclusion of the study, participants will be asked in a separate Photo Release Form if they would provide 
permission to study personnel to use their photographs in research manuscripts, grant proposals, educational 
presentations, and other media presentations (see Appendix E).  
 
All 4 groups are asked to provide an active email address and instructed to complete a short series of questions 
nightly that will be emailed to them from our lab email Gmail address. The email will include a link to a survey 
powered by Google Docs, which includes the MDES, modified to ask participants about feelings experienced during 
the past 24 hours (see above for description), and 6-9 additional questions designed specifically for this study (see 
Appendix D for questionnaires designed for both the active and control groups). The 3 active condition groups are 
also asked to complete a nightly savoring exercise and to answer several questions about the exercise via a link to 
the exercise sent to their email (see Appendix D). 
 
Participants in all 3 active control groups will also be given the opportunity to choose whether they would like to 
be reminded to take photographs via text message or email. The text messages will be generated from the study 
Gmail account. Participants are reminded in the consent form that they are responsible for any charges accrued for 
receiving text messages if they choose that option. 
 
At the end of each 7 day period, participants in the active Picture This! Plus Social Sharing Group are asked to 
share their photographs with a friend, relative, or loved one of their choice. Email reminders to complete the 
sharing exercise will be provided. The sharing should be done in person, rather than via email or over the phone. 
The participant may choose with whom to share the pictures and may decide to show the same person his/her 
pictures each week for the 3 week period or may decide to share with different people each week or some 
combination thereof. Scripts are provided to guide the participants (see Appendix B). Given that the participants 
may have taken many more than the required photographs during the prior week for this project, the time it takes 
to share them will vary. However, participants will be asked to limit the interaction to approximately 15 minutes. 
Participants in the Picture This! group and the Document This! control group are not asked to share their 
photographs. Following the sharing activity, participants in the Picture This! Plus Social Sharing Group are asked to 
answer 5 questions online, again following a link they will have received by email (see Appendix E). To keep 
payment equal, all other participants are also asked to complete a weekly survey of 5 questions about taking and 
sharing photographs. 
 
At the completion of the 3rd 7 day period, all participants will be invited back into the laboratory to complete an 
exit questionnaire packet and to repeat the 2 computerized tasks they completed at baseline. This packet will 
include the following measures: 
 
 
1) Demographics and Psychiatric History Follow-up 
2) Modified Differential Emotion Scale (MDES) 
3) Self-Other Four Immeasurables Scale  
4) Ambiguous Situation (with 10 novel statements) 
5) Santa Clara Brief Compassion Scale 
6) Gratitude Questionnaire (GQ-6)  
7) Cognitive Style Questionnaire Short Form (CSSF) 
8) Beck Depression Inventory – II (BDI-II) 
9) State-Trait Anxiety Inventory (STAI) 
10) Savoring Beliefs Inventory (SBI)  
11) Carolina Empirically Derived Mindfulness Inventory (CEDMI) 
12) Brief Satisfaction with Life Scale (BSWLS)  
13) Rosenberg Self Esteem  
14) Scale of Physical Symptoms 
15) Pittsburgh Sleep Quality Inventory (PSQI) 

16) Social Connectedness Scale (SCS) 
17) MOS Social Support Scale (MOS) 
18) Perceived Stress Scale (PSS) 
19) Life Events Scale (LES) Respondents will be asked to consider the time that has elapsed since baseline 
(which should be approximately 4-5 weeks).  
20) Emotion Regulation Questionnaire (ERQ)  
21) TOSCA-3 with 16 novel scenarios 
22) Irritability Question 
23) Intervention Assessment – 5 questions created by the project staff to assess participant satisfaction with 
prescribed exercises and to elicit suggestions for improvement. 
 
The following compensation/incentive schedule for completing questionnaires and participating in the study will 
be utilized: 
• 
Participants who complete the baseline questionnaire packet and computer tasks will be compensated 
$10 or be provided with class credit via the psychology subject pool. 
• 
Participants who complete the exit questionnaire packet and computer tasks will be compensated $19 or 
be provided with class credit via the psychology subject pool. 
• 
Participants will be compensated $1/day for completing the nightly online questions for a potential total 
of $21. 
• 
Participants will be compensated $1/each weekly survey completed for a potential total of $3. 
 
Hypothesized Outcomes 
H1: Participants in the Picture This! (PT) and Picture This! Plus Social Sharing (PTPSS) conditions will evidence 
increased well-being as indexed by measures of: a) depressive symptoms, b) positive affect, c) savoring beliefs, d) 
mindfulness e) life satisfaction, f) self esteem, g) gratitude, h) physical health and sleep quality, and i) perceived 
social support, relative to participants in the active control and no picture control conditions. 
H2: Participants in the Pictures This! Plus Social Sharing will demonstrate greater improvement in perception of 
social support than those in any other condition.  
Mediators of Change. 
H3: Participants in the PT and PTPSS conditions will show significant changes in automatic cognitive processes 
including attentional biases, interpretational biases, and cognitive style assessed via behavioral tasks and self 
report. 
H4: Changes in the aforementioned cognitive processes will account for the positive changes in mental and 
physical health.  
H5: Participants in the PS and PTPSS conditions will demonstrate significant changes in behavioral indicators of 
attentional shifts. We anticipate participants in the active experimental conditions will a) take increasingly more 
photographs over the course of the intervention and b) will include more social behavior as the focal point. 
Supplementary Analyses 
H6, exploratory: In order to inform future implementation and potential mechanisms of change, we will examine 
photographic content. We also anticipate changes in the quality of the photographs over the course of the 
intervention for the participants in both active experimental conditions. It is possible that the photographic 
content would be judged by independent raters to be increasingly positive over the course of the intervention. 
Alternatively, it is plausible that as the participant’s ability to attune to the positive cues in the environment 

develops, the capacity to find joy in even the most mundane objects/moments will be evident in photographs 
judged by independent raters to have less objectively rated positive appeal.  
H7: Depressive symptoms will moderate the associations between intervention participation and daily positive 
affect, life satisfaction, and perceived social support, such that participants with higher levels of pre-intervention 
symptoms will show larger improvements in outcomes in the intervention conditions.  
H5b and H6 are straightforward between-groups analyses, for which we will use ANOVA to test for significant 
differences between groups on the outcomes of interest. H1-H3 and H5a will be tested using mixed-factor ANOVA, 
with condition as a between-subjects factor and the within-subjects factor being pre-intervention measure of the 
outcome of interest included as predictors of the post-intervention outcome (e.g., perceived social support). 
Planned contrasts will probe for significant differences in effects between the experimental conditions and each 
control condition, as appropriate. H7 will be tested using two additional predictors, the main effect of the 
individual difference of interest (e.g., depressive symptoms) as well as the interaction between the individual 
difference and condition. H4 (mediation) will be tested using the most up-to-date evidence for bootstrapping 
estimates (see Hayes; Preacher & Hayes, 2008).  
Finally, the daily reports will provide critical information about how long the intervention may take to set in (see 
Fredrickson et al., 2008) and whether there is an optimal training period; likewise, the daily photographic evidence 
may be quantified to determine degree of positivity and social connection, which may show increases over time 
(see H5a). Algoe will conduct more complex statistical tests including exploratory growth curve analyses to test for 
this information that will optimize future implementation.