Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission.

1. In a prospective cohort study, frequent adolescent social media use was associated with changes in the brain’s sensitivity to social rewards and punishments, as measured by functional magnetic resonance imaging (fMRI).

2. Habitual social media users had hypoactive responses to social rewards in early adolescence but increased sensitivity over time. By the end of the study, habitual social media users had a greater response to social rewards than their peers.

Evidence Rating Level: 2 (Good)

Study Rundown:

Access to social media has exploded in the last generation. The social cues these media platforms offer may be especially impactful for adolescents, who are in a critical period of neurodevelopment. Using a prospective cohort of 169 adolescents, this study aimed to assess the longitudinal impact of social media checking habits on the brain’s sensitivity to social rewards and punishments. The authors found an inverse relationship between the frequency of social media checking and neural sensitivity to social cues over time. Their results suggest that, in early adolescence, decreased neural reactivity to social rewards is associated with more frequent social media use. However, over time, greater social media use sensitizes neurocircuitry to these social cues, leading to hyperresponsiveness. In practice, this indicates that adolescent social media use patterns may have significant implications for social functioning and psychological adjustment later in life. Strengths of this study include the recruitment of a diverse sample of children (22.5% Black, 35.5% Latinx, 29.6% White, 8.9% Multiracial, and 3.6% Other), as well as longitudinal follow-up. However, the findings are limited by the small sample size, the lack of data on social media usage prior to study enrollment, and particularly by the modeling strategy implemented, which did not include any demographic or psychologic covariates. Recent studies have shown accounting for such variables (i.e., socioeconomic status, race/ethnicity, internalizing symptoms, other social ties, etc.) can significantly alter results.

In-Depth [prospective cohort]:

This study drew from a larger cohort of rural middle school students in North Carolina. Social media habits were measured via self-report surveys taken at baseline (mean age, 12.89 years), which asked how many times per day participants checked Facebook, Instagram, and Snapchat. Continuous scores (range, 0-54; mean, 11.85) were used in primary analyses; these were later converted to a three-level categorical variable (habitual use, >15; moderate use, 1-15; non-habitual use, 0) to explore a significant interaction between age and social media behaviors. The outcome, neural sensitivity to social cues, was assessed using a social incentive delay fMRI task. Longitudinal whole brain analyses were used to identify regions of interest (minimum cluster size was set to 80 voxels, as determined via Monte Carlo simulation, to account for multiple comparisons). Next, generalized linear models, adjusted for motion nuisance parameters, were used to assess the longitudinal relationship between social media habits at baseline and trajectories of neural responses to the social incentive task. The final sample was comprised of 169 adolescents. Significant interactions between age and social media habits were found in four primary brain regions: (1) the left amygdala, extending into the posterior insula and ventral striatum; (2) the right amygdala; (3) the anterior insula; and (4) the left dorsolateral frontal cortex. In all four, the patterns were the same: Habitual social media users had hypoactive responses at baseline, but increased responses over time; while non-habitual social media users had hyperactive responses at baseline, but decreased responses over time (p<0.05 for all). This resulted in habitual social media users having greater response to social rewards than their peers by the end of the follow-up period.

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