Social Media Concerns Related to Emotional Experiences in Naturalistic Settings (SCREENS)

The study aims to enroll 100 participants recruited from the TX-YDSRN registry study. TX-YDSRN registry study, an ongoing state-wide longitudinal data repository funded by Texas Child Mental Healthcare Consortium (TCMHCC). TX-YDSRN is comprised of 12 participating HRIs across Texas.

Eligible and active TX-YDSRN participants will be invited to participate in this study. Efforts will be made to ensure a diverse and representative sample, including participants of varying sexes, ethnicities, races, and socioeconomic backgrounds. The TX-YDSRN's established recruitment network and community partnerships since 2020 support broad and inclusive enrollment.

Advances in mobile health (mHealth) technologies offer new ways to monitor depression and suicidal ideation outside of clinical settings. Through smartphones and devices from wearable health technology leaders such as Garmin or Fitbit, this study aims to remotely track clinical indicators among youth. These technologies collect data such as physical activity, social interaction, sleep, social media experiences, social media use amount, and mood in real-time, providing an ecologically valid picture of the participants' daily lives. This approach can enhance early detection of clinical deterioration, empowering both participants and caregivers with timely, actionable feedback.

Using HIPAA-compliant software on smartphones, the app will track digital markers such as location, movement, call/text frequency, screen time, and survey responses as proxies for social interaction, in-person social support, anxiety, suicidal ideation/behavior, emotional responses to social media, and mood. Data is encrypted, stored on secure servers ensuring confidentiality. Similarly, wearables will track digital biomarkers such as sleep patterns, heart rate, and activity levels. Together, these metrics offer continuous, longitudinal data on various potential markers for physical and psychological health such as the following:

• Activity Levels: Reduced physical activity and social engagement may indicate worsening depression. Tracking changes in the radius of daily movement can help detect reduced interest and motivation to engage in important or valued activities.
• Sleep Patterns: Sleep issues (insomnia, hypersomnia, disruption, restlessness) often signal mood changes. By monitoring sleep latency, duration, and quality, we can identify early warning signs of depression.
• Social Interaction: Decreases in communication frequency and network size, changes in screen time, can indicate social withdrawal.
• Mood Variability: Regular assessments of mood, fatigue, and energy help capture emotional variability. Non-responsiveness itself can be a potential marker of worsening of depression.