AI-Supported Digital Health Interventions to Counter Belief Vulnerabilities: Performance-Enhancing Substance Use Intentions Are Predicted by Social Cynicism

Performance-enhancing substance (PES) use extends beyond elite sport, yet prevention efforts lack empirically grounded models of the cognitive vulnerabilities underlying substance use decisions. This study examines how social cynicism – a generalized negative social worldview – shapes intentions to use mental and physical performance-enhancing substances (PES) via cognitive appraisals of perceived benefits and harms. In a cross-sectional study of German and Austrian university students (N = 387), social cynicism positively predicted inflated perceptions of PES benefits, but did not reduce perceived unpleasantness of side effects. Mediation analyses revealed indirect effects of social cynicism on PES intentions via increased benefit appeal, whereas unpleasantness played no significant mediating role. These results highlight a benefit-focused cognitive bias that predisposes cynical individuals toward PES use. Building on this pathway, we propose intelligent digital health interventions – such as real-time cognitive reappraisal companion tools – that monitor users’ belief profiles and deliver personalized intervention nudges to reduce risk-prone substance-based enhancement behaviors.