An interventional study of Rejection and Acceptance Feedback in Depression, sponsored by University of Pittsburgh. Recruiting at 1 site in United States. Open to participants aged 13 Years to 17 Years. Per ClinicalTrials.gov, last updated 2026-05-06.
Sponsored by University of Pittsburgh · Not applicable, Interventional, and Basic science
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:
Participants will be asked to:
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.
8,577 studies on the registry are indexed under Depression; 1,720 are open to participants now.
This study's planned enrollment of 60 is below the median of 81 across 7,063 interventional studies indexed under Depression.
Browse Depression studies →University of Pittsburgh is the lead sponsor of 1,419 studies on the registry; 168 are open to participants now.
Of its 9 completed or terminated interventional studies of FDA-regulated products, 4 (44%) have results posted.
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Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
Contraindication
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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)
Behavioral: Rejection and Acceptance Feedback
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.
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.
Time frame: During the MRI Scan/intervention (occurring once ~4 weeks into the study)
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.
Time frame: 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).
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
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").
Time frame: 3 times a day for 16 days
Plan to share: Yes — All individual participant data collected during the study, after deidentification, may be shared.
Supporting information: Study protocol, Statistical analysis plan, Informed consent form, Analytic code
Time frame: Scientific data will be made accessible no later than 1 year after the grant end date. Any subject level data and associated analyzed data will be shared at time of publication. No end date.
Access criteria: Deidentified data will be submitted to and made available on the National Institute of Mental Health Data Archive (NDA). To obtain data access, researchers will follow the established procedures within NDA, and the NDA Data Access Committee will determine the approvals for these requests. Access will be given for any legitimate scientific purpose, as determined by NDA Access Committee.
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