Social Media Effects for Teen Depression

(TBO-II Trial)

Overseen By Sarah E Nelson, B.S.

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: University of Pittsburgh

Must not be taking: CNS medications

Disqualifiers: Neurological, Medical, Pregnancy, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 3

60 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

You can continue taking your current antidepressants if you are on a stable dose. However, if you are taking stimulants, you will need to stop them 36 hours before the MRI scan.

What data supports the effectiveness of the treatment Rejection and Acceptance Feedback for teen depression?

Research shows that social media interventions, like moderated online social therapy, can help young people with depression by providing a supportive environment and enhancing engagement. Additionally, using platforms like Facebook with professional support has been shown to improve depression symptoms, suggesting that social media can be a useful tool in treating depression. ^{1 2 3 4 5}

Is the treatment of social media effects for teen depression generally safe?

The research suggests that social media use can lead to increased emotional distress, self-harm, and suicidal thoughts in vulnerable adolescents. This indicates potential safety concerns for using social media as a treatment for teen depression. ^{6 7 8 9 10}

How does the Rejection and Acceptance Feedback treatment differ from other treatments for teen depression?

The Rejection and Acceptance Feedback treatment is unique because it focuses on the impact of social media interactions, specifically how receiving feedback like 'likes' or comments can affect teens' emotions and self-perception. Unlike traditional treatments that might focus on medication or talk therapy, this approach considers the role of online social dynamics in managing depressive symptoms. ^{5 8 10 11 12}

What is the purpose of this trial?

There has been much interest in the potential role of social media (SM) use in driving a current mental health crisis among teens, with a dire need for evidence that goes beyond self-report. One important avenue is to understand the role of the brain in driving the effects of SM use on emotional health and vice versa. However, there is almost no research addressing these questions, largely due to a lack of tasks that can probe the neural correlates of modern SM use. The goal of this clinical trial is to develop and validate a new developmentally-appropriate and ecologically-valid functional magnetic resonance imaging (fMRI) and eyetracking task, the TeenBrainOnline (TBO) Task, that is more realistic and similar to modern SM platforms. Participants will be 50 teens (ages 13-17) with depressive symptoms who will complete the final version of TBO task during fMRI with eye-tracking, an older Chatroom Interact (CHAT-I) Task, daily surveys of SM use, and measures of depressive symptoms. Our goal is to show that the task works by: * Demonstrating that it activates expected regions of the brain and visual attention biases toward feedback cues. * Showing that brain and eyetracking (visual attention) activity on the task explain variability in depressive symptoms at baseline and three months later, and work better than similar indices from an older task. * Showing that brain and eyetracking (visual attention) activity on the task are associated with real-world measures of social media use collected during daily surveys. Specifically, The investigators expect that teens whose brain and eyetracking activity suggests they are more sensitive to feedback on SM will report a social evaluation orientation toward social media use in daily life, such as engaging a lot in social comparison, worrying about missing out, and caring about getting a lot of likes and comments. Participants will be asked to: * complete a 10-15 minute screening call to determine eligibility for the study * complete one 90 minute virtual study visit to complete questionnaires and prepare for the MRI visit (visit 1) * submit 24 photos to our study specific social media site * complete an (in person) MRI scan visit (\~4 hours), which consists of 2 tasks where they will interact with peers (visit 2) * complete \~5 minute smartphone surveys 3 times a day for 16 days, asking about their daily experiences online and emotional reactions. * complete 2 online questionnaires asynchronously 3 months after their scan date

Research Team

Jennifer S Silk, Ph.D

Principal Investigator

University of Pittsburgh

Helmet T Karim, Ph.D.

Principal Investigator

University of Pittsburgh

Eligibility Criteria

This trial is for teens aged 13-17 with symptoms of depression. They must be willing to undergo an MRI scan, interact on a study-specific social media site, and complete daily surveys about their online experiences and emotions.

Inclusion Criteria

I am between 13 and 17 years old.

Depression screening scores on the MFQ-C in the mild (MFQ = 12-25; N = 20) or moderate-to-severe range (MFQ ≥25; N=30)

I own a smartphone to do health surveys online.

Exclusion Criteria

My child has a serious neurological or medical condition.

I cannot complete assessments due to language barriers or cognitive issues.

Presence of probable substance use disorder, as determined by participant report

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

1 visit (virtual)

Preparation

Participants complete a virtual study visit to complete questionnaires and prepare for the MRI visit

1 week

1 visit (virtual)

Intervention

Participants complete the TBO and CHAT-I tasks during fMRI/eye-tracking at the BRIDGE MRI Center

4 weeks

1 visit (in-person)

Daily Surveys

Participants complete smartphone surveys 3 times a day for 16 days about their daily experiences online and emotional reactions

16 days

Follow-up

Participants complete online questionnaires asynchronously 3 months after their scan date to assess depressive symptoms

3 months

Treatment Details

Interventions

• Rejection and Acceptance Feedback

Trial Overview The TeenBrainOnline Task aims to understand how social media affects teen brains by using fMRI and eyetracking. It compares brain activity during simulated social media interactions with real-world SM use patterns and depressive symptoms.

Participant Groups

Group I: Adolescents aged 13-17 with at least mild symptoms of depression Experimental Treatment 1 Intervention

Adolescents in Phase 2 will be screened for depressive symptoms using the MFQ-c. 20 teens will have MFQ-c scores within the mild range (MFQ = 12-25). The sample will be stratified, with 30 teens who will have moderate to severe depressive symptoms as assessed by the MFQ-C. (MFQ ≥25; N=30)

Who Is Running the Clinical Trial?

University of Pittsburgh

Lead Sponsor

Trials

1,820

Recruited

16,360,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

References

1. United States pubmed.ncbi.nlm.nih.gov

Depressive symptomatology, youth Internet use, and online interactions: A national survey. [2022]

2. England pubmed.ncbi.nlm.nih.gov

Depressed adolescents' positive and negative use of social media. [2023]

3. Netherlands pubmed.ncbi.nlm.nih.gov

A next-generation social media-based relapse prevention intervention for youth depression: Qualitative data on user experience outcomes for social networking, safety, and clinical benefit. [2023]

4. United States pubmed.ncbi.nlm.nih.gov

Facebook enhances antidepressant pharmacotherapy effects. [2021]

5. United States pubmed.ncbi.nlm.nih.gov

Are Aspects of Twitter Use Associated with Reduced Depressive Symptoms? The Moderating Role of In-Person Social Support. [2020]

6. India pubmed.ncbi.nlm.nih.gov

The role of online social networking on deliberate self-harm and suicidality in adolescents: A systematized review of literature. [2020]

7. United States pubmed.ncbi.nlm.nih.gov

Past Year Technology-Involved Peer Harassment Victimization and Recent Depressive Symptoms and Suicide Ideation Among a National Sample of Youth. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

Getting Fewer "Likes" Than Others on Social Media Elicits Emotional Distress Among Victimized Adolescents. [2021]

9. Canada pubmed.ncbi.nlm.nih.gov

An Analysis of Depression, Self-Harm, and Suicidal Ideation Content on Tumblr. [2022]

10. United States pubmed.ncbi.nlm.nih.gov

"Facebook depression?" social networking site use and depression in older adolescents. [2022]

11. United States pubmed.ncbi.nlm.nih.gov

Using Social Media for Social Comparison and Feedback-Seeking: Gender and Popularity Moderate Associations with Depressive Symptoms. [2022]

12. United States pubmed.ncbi.nlm.nih.gov

Adolescents' Depressive Symptoms and Subsequent Technology-Based Interpersonal Behaviors: A Multi-Wave Study. [2019]