Social Media Concerns Related to Emotional Experience in Naturalistic Settings: SCREENS - PROJECT SUMMARY/ABSTRACT Rising rates of internalizing symptoms, including depression, anxiety, and suicidal ideation, in youth in the US represent a public health crisis. In 2024, 40% of youth experienced a past-year persistent sadness or hopelessness and 29% reported past-month poor mental health (i.e., depression, anxiety, or stress), while suicide has consistently ranked in the top three causes of death for youth aged 13-18. Coinciding with the increase in internalizing symptoms, social media use has rapidly grown, but the link between social media use and mental health is not well understood, especially in at-risk, clinical populations. Moreover, most research on the topic has been cross-sectional, lacking information about the impact of social media use on proximal and longer-term outcomes for internalizing symptoms. It also often fails to consider both ways in which social media use may be harmful and protective. There is a critical need for longitudinal research on social media’s relationship with internalizing symptoms in youth and risk and protective factors for individuals. Therefore, we propose a study in response to RFA-MH-25-206 (Bidirectional Influences Between Adolescent Social Media Use and Mental Health) that uses longitudinal and intensive monitoring on multiple timescales to identify how social media use and experiences are linked to internalizing symptoms in a sample of at-risk youth. The proposed study will enroll N=100 youth aged 13-18 years recruited from the University of Texas Southwestern Node of the ongoing Texas Youth Depression and Suicide Research Network (TX-YDSRN) Registry study. The Registry enrolls youth with depression and/or suicidal thoughts or behaviors, so participants have high rates of internalizing symptoms. At baseline, internalizing symptoms and social experiences (i.e., victimization) will be collected via clinical interview and self-report; subsequently, internalizing symptom self-report measures will be collected monthly for six months. Participants will complete ecological momentary assessments (EMA) twice daily during the first month, with questions on real-time positive and negative Emotional Responses to Social Media, internalizing symptoms (i.e., depression, anxiety, and suicidal ideation), and positive and negative in-person interactions. Objective social media use data (i.e., use duration), along with EMA, will be collected via a smartphone app (mHealth). Using these data, this proposal aims to: (1) Investigate how amount of social media use and positive/negative experiences impact internalizing symptom trajectories over six months and (2) Determine social context factors impacting the relationship between social media use amount and experiences and internalizing symptoms. Throughout the project, the established TX-YDSRN youth advisory board (N = 15) will be consulted to inform study approach, data interpretation, and dissemination of study findings. This proposed R21 will generate pilot data for a future R01 application aimed at state-wide investigation of social media use and mental health in Texas youth. Results of this project have the potential to inform clinical interventions and prevention programs to promote youth mental health in the context of social media.
