DepressionTBO-IINCT06817993
Teen Brain Online II: Understanding How Social Media Affects the Teen Brain
A study testing Rejection and Acceptance Feedback in people with Depression, run by University of Pittsburgh at 1 site in United States.
Trial summary
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. Read more about this study
- Who is it for?
- Ages 13 to 17 years
- Conditions the study is for
- Depression
- What is being tested?
- Rejection and Acceptance Feedback
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 1 siteUnited States
- Study dates
- 21 Mar 2025to 30 Mar 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 13 to 17 years
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- Between ages 13-17
- Depression screening scores on the MFQ-C in the mild (MFQ = 12-25; N = 20) or moderate-to-severe range (MFQ ≥25; N=30)
- Possess their own smartphone to complete web-based ecological momentary assessments (EMA) using WebDataExpress.
- use social media apps (e.g. Instagram, twitter, reddit, discord, YouTube, etc.) at least 3 times a week, on average, per teen report
Who cannot join
- Presence of a serious neurological or medical condition, by parent report
- Unable to read or speak English or cognitive impairment preventing ability to complete assessments.
- Hearing impairment preventing ability to hear and understand instructions conveyed via headphones in the MRI scanner
- Possible pregnancy, as determined by participant report
- Presence of probable substance use disorder, as determined by participant report
- Presence of MRI contraindications (e.g., dental braces, history of metallic foreign objects in body such as aneurysm clips or other devices or questionable history of metallic fragments, claustrophobia, or a weight of above 300 lbs)
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- Taking medications that affect the central nervous system other than antidepressants (stable dose allowed due to high rates of use among teens with depressive symptoms) or stimulants if required 36 hours before the scan.
- Completion of Chatroom Interact Task or TBO Task in prior studies
- Screening positive on the Autism Spectrum Screening Questionnaire, or screening positive on the Youth Inventory-4/ for a potential psychotic disorder or substance use disorder.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
United States1 site, 1 recruiting
- Recruiting
University of Pittsburgh
Pittsburgh, Pennsylvania, 15213
Jennifer S Silk, Ph.D, 412-624-4428, jss4@pitt.edu
Sarah E Nelson, B.S., 443-933-0785, SEN102@pitt.edu
About this study
Official title: Development of a New Social Media fMRI Task to Better Investigate Bidirectional Links Between Social Media Use and Emotional Health in Youth
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.
Read more
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
Read the detailed description
There is no assignment to conditions. All participants will receive the same intervention, which is the completion of two experimental tasks that present participants with opportunities to receive feedback from peers. Phase 1 focuses on task development with 10 participants, where they will complete a screening call, a 60 virtual screening call with questionnaires and preparation for the fMRI tasks (TBO and CHAT) described below. They will then complete the Teen Brain Online (TBO) and Chatroom Interact (CHATI) tasks during fMRI/eye-tracking at the BRIDGE MRI Center in a counterbalanced order (with half of the participants randomly assigned to complete the CHAT task first, and the other half randomly assigned to complete the TBO task first), approximately one month following the screening visit. Phase 1 participants will not have EMA text message surveys or a 3 month follow up visit. During Phase 2 (~months 9-24), the final version of TBO will be tested in 50 youth with elevated depressive symptoms. Following a phone screen, youth will complete a virtual screening visit that includes questionnaires and preparation for the fMRI tasks. They will then complete the Teen Brain Online (TBO) and Chatroom Interact (CHATI) tasks during fMRI/eye-tracking at the BRIDGE MRI Center in a counterbalanced order, approximately one month following the screening visit, as well as measures of depressive symptoms at three months (Mood and Feelings Questionnaire (MFQ).
Before the MRI visit, youth are asked to submit 24 selfies, a profile picture, and a handle for a study specific social media site All participants will get a chance to view the site before their MRI scan to view and interact with posts, through likes and comments systems. During the TBO task within the scanner, the participants will be shown their own posts and the posts of other teens in the study alongside each other. They will also be shown the number of likes, comments, and views on each post. The investigators will assess their neural reactions to the posts, and also use eye tracking to see what they are paying attention to on screen. The Investigators will also assess the teen's reactions to 3 of their posts comment's sections. In the inter-block intervals, the investigators will also show them trials with 2 peer photos to control for the effect of seeing images of peers vs themselves. The placement of participant and peer photos are random (left vs right), and no photos will be repeated.
For the CHAT-I Task, participants will view photos and biographies for same-age youth and choose the top five that they would like to interact with from other research sites. They will have their own photo taken (via screenshot) and provide a biography for their own profile. They will be matched with two of the five available peers, and will interact with them in the scan. During the CHAT-I task in the scanner, the participant and peers take turns selecting who they would rather talk to about a series of topics (e.g., music, movies). The first block is a neutral condition in which a dot appears over the picture of one person, and the participant presses a button indicating on which side the dot appeared. The chat game then proceeds in three blocks, where the participant and the peers will take turns selecting who they would like to talk to.
Teen participants will also complete a 16-day EMA protocol (two school weeks, three weekends) using Web-DataExpress. This approach will allow us to obtain nuanced information about SM experiences beyond frequency/duration of use. Following our standard procedures, they will be randomly sampled within three blocks of time (morning, after school, evening) for a total of 48 surveys. Youth can "snooze" each prompt for up to one hour, and the after-school prompt allows youth to report SM use during the school day.
Certain information is withheld to protect the scientific integrity of the study design.
- Conditions
- Depression
- Being tested
- Rejection and Acceptance Feedback
- Keywords
- Depression, Adolescent, Teen, Social Media, Social Acceptance, Social Rejection, fMRI, Neuroimaging
- Medical subject headings
- Depression, Social Isolation
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Rejection and Acceptance FeedbackBehavioural
Participants will be administered cues of peer acceptance and rejection from virtual peers during an fMRI task. In the CHAT-I task, they will be chosen or not chosen to discuss various topics with a virtual peer. In the TBO Task, they will receive a high or low number of likes relative to the other photos displayed of peers. They will also view comments on their posts from peers, which may have positive, negative, or neutral content.
| Study group | Role | What they receive |
|---|---|---|
| Adolescents aged 13-17 with at least mild symptoms of depression | Experimental | 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) Receives: Behavioral: Rejection and Acceptance Feedback |
What is being measured
The primary outcome is the main question the study is designed to answer.
Average Affective Salience Network Activation to Social Reward and Threat stimuli
The investigators will measure neural activity (as measured by fMRI response) in regions within the Affective Salience network (ASN) in response to social threat and reward in the TBO and CHAT-I tasks. Average activation will be compared in each region between experiences of social reward, social threat, and neutral experiences as well as baseline.
Measured: During the MRI Scan/intervention (occurring once ~4 weeks into the study)
Secondary outcomes (3)
Depressive Symptoms Score as Assessed by the MFQ-C
Depressive symptoms are measured measured by the Mood and Feelings Questionnaire-child. (MFQ-c), at baseline at a screening call, concurrently at the time of scan visit, and at 3 months. Scores on this assessment are measured continuously and will be assessed for their correlation with other outcome measures.
Measured: baseline (phone screen), immediately before the Intervention, 3 months
Average Visual Fixation time to Social Reward and Threat stimuli
The Investigators will measure eye-tracking fixations of over 50 ms to areas of interest (AOIs) in the TBO task, including the self-photo, other-photo, likes, views and comments numbers, and the comments themselves. Gaze duration will be computed for each AOI divided by the total length of the trial for each condition, then average gaze durations across all trials within each condition (reward, threat, neutral).
Measured: During the MRI Scan/intervention (occurring once~4 weeks into the study)
Reported Emotional Experiences of Threat and Reward during Daily Social Media Use
Participants will be asked to select which SM apps they used since their last survey, and their reported passive/active behaviors, using validated items from Common Sense Media. They will then rate several aspects on a 0-100 slider. They will rate social comparison orientation using an item adapted from Nesi's Emotional Responses to SM Scale - Revised. Digital status seeking will be assessed using behaviors from Nesi's digital status seeking measure. Online FoMO will be assessed with items from the online adaptation of the FoMO scale. Affective responses to SM will be assessed by having youth nominate their most positive and negative experiences via SM since the last survey and rate their associated positive affect (PA; average of "happy," "joyful," "interested," "excited") and negative affect (NA; average of "worried," "stressed," "mad", "sad").
Measured: 3 times a day for 16 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Feb 2025
- Study start21 Mar 2025
- Primary completion30 Mar 2027 (estimated)
- Study completion30 Mar 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for DepressionStudies of the same condition, open and under way.
- More trials run by University of PittsburghThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Basic science
- Allocation
- Not applicable
- Intervention model
- Single group
- Model description
- All participants will be similar (13-17 with at least mild depression symptoms) and will experience the same procedures.
- Masking
- None (open label)
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Pittsburgh
- Sponsor type
- University, hospital or other
- Collaborators
- National Institute of Mental Health (NIMH)
- Responsible party
- Principal investigator, Jennifer Silk, University of Pittsburgh
- Investigators
- Jennifer S Silk, Ph.D, Principal investigator, University of PittsburghHelmet T Karim, Ph.D., Principal investigator, University of Pittsburgh
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06817993
- Sponsor's protocol ID
- STUDY24100085
- Other IDs
- 1R21MH138955-01
- Acronym
- TBO-II
- Status last verified
- May 2026
- First submitted
- 20 Dec 2024
- Last updated
- 6 May 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: All individual participant data collected during the study, after deidentification, may be shared.
Study at a glance
From the registry record, last updated by the sponsor on 6 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Development of a New Social Media fMRI Task to Better Investigate Bidirectional Links Between Social Media Use and Emotional Health in Youth
- ClinicalTrials.gov ID
- NCT06817993
- Acronym / sponsor ID
- TBO-II / STUDY24100085
- Conditions
- Depression
- Keywords
- Depression, Adolescent, Teen, Social Media, Social Acceptance, Social Rejection, fMRI, Neuroimaging
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 60 participants (estimated)
- Lead sponsor
- University of PittsburghUniversity, hospital or other
- Collaborators
- National Institute of Mental Health (NIMH)
- Study start
- 21 Mar 2025 (actual)
- Primary completion
- 30 Mar 2027 (estimated)
- Study completion
- 30 Mar 2027 (estimated)
- First posted
- 10 Feb 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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
Detailed description
There is no assignment to conditions. All participants will receive the same intervention, which is the completion of two experimental tasks that present participants with opportunities to receive feedback from peers. Phase 1 focuses on task development with 10 participants, where they will complete a screening call, a 60 virtual screening call with questionnaires and preparation for the fMRI tasks (TBO and CHAT) described below. They will then complete the Teen Brain Online (TBO) and Chatroom Interact (CHATI) tasks during fMRI/eye-tracking at the BRIDGE MRI Center in a counterbalanced order (with half of the participants randomly assigned to complete the CHAT task first, and the other half randomly assigned to complete the TBO task first), approximately one month following the screening visit. Phase 1 participants will not have EMA text message surveys or a 3 month follow up visit. During Phase 2 (~months 9-24), the final version of TBO will be tested in 50 youth with elevated depressive symptoms. Following a phone screen, youth will complete a virtual screening visit that includes questionnaires and preparation for the fMRI tasks. They will then complete the Teen Brain Online (TBO) and Chatroom Interact (CHATI) tasks during fMRI/eye-tracking at the BRIDGE MRI Center in a counterbalanced order, approximately one month following the screening visit, as well as measures of depressive symptoms at three months (Mood and Feelings Questionnaire (MFQ).
Before the MRI visit, youth are asked to submit 24 selfies, a profile picture, and a handle for a study specific social media site All participants will get a chance to view the site before their MRI scan to view and interact with posts, through likes and comments systems. During the TBO task within the scanner, the participants will be shown their own posts and the posts of other teens in the study alongside each other. They will also be shown the number of likes, comments, and views on each post. The investigators will assess their neural reactions to the posts, and also use eye tracking to see what they are paying attention to on screen. The Investigators will also assess the teen's reactions to 3 of their posts comment's sections. In the inter-block intervals, the investigators will also show them trials with 2 peer photos to control for the effect of seeing images of peers vs themselves. The placement of participant and peer photos are random (left vs right), and no photos will be repeated.
For the CHAT-I Task, participants will view photos and biographies for same-age youth and choose the top five that they would like to interact with from other research sites. They will have their own photo taken (via screenshot) and provide a biography for their own profile. They will be matched with two of the five available peers, and will interact with them in the scan. During the CHAT-I task in the scanner, the participant and peers take turns selecting who they would rather talk to about a series of topics (e.g., music, movies). The first block is a neutral condition in which a dot appears over the picture of one person, and the participant presses a button indicating on which side the dot appeared. The chat game then proceeds in three blocks, where the participant and the peers will take turns selecting who they would like to talk to.
Teen participants will also complete a 16-day EMA protocol (two school weeks, three weekends) using Web-DataExpress. This approach will allow us to obtain nuanced information about SM experiences beyond frequency/duration of use. Following our standard procedures, they will be randomly sampled within three blocks of time (morning, after school, evening) for a total of 48 surveys. Youth can "snooze" each prompt for up to one hour, and the after-school prompt allows youth to report SM use during the school day.
Certain information is withheld to protect the scientific integrity of the study design.
Study design
- Primary purpose
- Basic science
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
- Model description
- All participants will be similar (13-17 with at least mild depression symptoms) and will experience the same procedures.
| Arm | Type | Receives |
|---|---|---|
| Adolescents aged 13-17 with at least mild symptoms of depression | Experimental | Behavioral: Rejection and Acceptance FeedbackAdolescents 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 may qualify
- Ages
- 13 to 17 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (4 listed)
- Between ages 13-17
- Depression screening scores on the MFQ-C in the mild (MFQ = 12-25; N = 20) or moderate-to-severe range (MFQ ≥25; N=30)
- Possess their own smartphone to complete web-based ecological momentary assessments (EMA) using WebDataExpress.
- use social media apps (e.g. Instagram, twitter, reddit, discord, YouTube, etc.) at least 3 times a week, on average, per teen report
Key exclusion criteria (9 listed)
- Presence of a serious neurological or medical condition, by parent report
- Unable to read or speak English or cognitive impairment preventing ability to complete assessments.
- Hearing impairment preventing ability to hear and understand instructions conveyed via headphones in the MRI scanner
- Possible pregnancy, as determined by participant report
- Presence of probable substance use disorder, as determined by participant report
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Rejection and Acceptance FeedbackParticipants will be administered cues of peer acceptance and rejection from virtual peers during an fMRI task. In the CHAT-I task, they will be chosen or not chosen to discuss various topics with a virtual peer. In the TBO Task, they will receive a high or low number of likes relative to the other photos displayed of peers. They will also view comments on their posts from peers, which may have positive, negative, or neutral content. | Behavioural | Adolescents aged 13-17 with at least mild symptoms of depression |
Primary outcome
Average Affective Salience Network Activation to Social Reward and Threat stimuli
Time frame: During the MRI Scan/intervention (occurring once ~4 weeks into the study)
The investigators will measure neural activity (as measured by fMRI response) in regions within the Affective Salience network (ASN) in response to social threat and reward in the TBO and CHAT-I tasks. Average activation will be compared in each region between experiences of social reward, social threat, and neutral experiences as well as baseline.
3 secondary outcomes
Depressive Symptoms Score as Assessed by the MFQ-C
Time frame: baseline (phone screen), immediately before the Intervention, 3 months
Average Visual Fixation time to Social Reward and Threat stimuli
Time frame: During the MRI Scan/intervention (occurring once~4 weeks into the study)
Reported Emotional Experiences of Threat and Reward during Daily Social Media Use
Time frame: 3 times a day for 16 days
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 May 2026.
- Individual participant dataSharing planned: Yes. All individual participant data collected during the study, after deidentification, may be shared.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Jennifer S Silk, Ph.D principal investigator
University of Pittsburgh
Helmet T Karim, Ph.D. principal investigator
University of Pittsburgh
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Rejection and Acceptance Feedback in people with Depression, run by University of Pittsburgh at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 6 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Jennifer S Silk, Ph.D (412-624-4428, jss4@pitt.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Average Affective Salience Network Activation to Social Reward and Threat stimuli (time frame: During the MRI Scan/intervention (occurring once ~4 weeks into the study)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 May 2026.