APA Citation
Maza, M., Fox, K., Kwon, S., Flannery, J., Lindquist, K., Prinstein, M., & Telzer, E. (2023). Association of Habitual Checking Behaviors on Social Media With Longitudinal Functional Brain Development. *JAMA Pediatrics*, 177(2), 160-167. https://doi.org/10.1001/jamapediatrics.2022.4924
Summary
This landmark study tracked 169 adolescents over three years using brain scanning to examine how habitual social media checking affects brain development. The key finding: teenagers who frequently checked social media showed progressive increases in how strongly their amygdala and insula—brain regions processing social threat and reward—responded to social situations. Non-habitual checkers showed the opposite pattern. This is the first longitudinal evidence that social media use may be literally reshaping the adolescent brain.
Why This Matters for Survivors
For survivors, this research validates a disturbing parallel: the brain changes caused by habitual social media use mirror those caused by growing up with narcissistic parents. The same regions that become hyperreactive from chronic unpredictability at home become hyperreactive from algorithmic unpredictability online.
What This Research Found
Maza and colleagues conducted a groundbreaking three-year longitudinal study using functional MRI to track how habitual social media checking relates to brain development in 169 adolescents. This represents the first longitudinal neuroimaging evidence that social media use may be causally reshaping the developing brain.
Habitual checkers showed progressive amygdala sensitisation. Adolescents who reported frequently checking social media (15+ times daily) showed increasing amygdala activation during social anticipation tasks over the three-year study period. The amygdala processes threat and emotional salience—its increasing reactivity suggests the brain is becoming more vigilant about social outcomes.
The anterior insula showed parallel changes. The anterior insula, which processes bodily signals and emotional awareness, also showed increasing activation in habitual checkers. This region is critical for the “gut feelings” about social situations. Its sensitisation suggests that habitual checkers are developing stronger visceral responses to social feedback.
Non-habitual checkers showed the opposite pattern. Adolescents who checked social media less frequently showed decreasing activation in these same regions over time—the normal developmental trajectory of reducing threat sensitivity as social competence increases. Habitual checkers are deviating from this healthy developmental path.
The key insight: social media may be disrupting normal social-emotional development. Adolescent brains typically become less reactive to social cues as they mature, reflecting growing confidence and emotional regulation. Habitual social media checking appears to reverse this trajectory, keeping the brain in a heightened state of social vigilance that resembles the neural signature of anxiety disorders—and of children raised in unpredictable environments.
How This Research Is Used in the Book
Maza’s research appears in Chapter 13: The Great Accelerant as central evidence that social media creates brain changes homologous to those caused by narcissistic parenting:
“Children of narcissistic parents show hyperactive amygdala response to social threat, the product of chronic unpredictability. Adolescents who habitually check social media show progressive increases in amygdala activation during social anticipation—the same structure, the same hypersensitivity, documented longitudinally over three years.”
The book uses this study to argue for “convergent damage”—different inputs (narcissistic parenting, social media) producing the same neural outputs because they exploit the same vulnerabilities:
“Apply this framework to the neural adaptations documented in this chapter. If depression spreads through networks to three degrees of separation, and if habitual social media use produces depression through documented neural mechanisms, then the neural reshaping does not remain confined to individual users. It propagates.”
The longitudinal design is particularly important to the book’s argument: previous cross-sectional studies couldn’t establish whether social media caused brain changes or whether pre-existing differences led to more social media use. Maza et al.’s design demonstrates that checking behavior predicts subsequent neural change—causation, not just correlation.
Why This Matters for Survivors
Your recognition of the pattern is validated by neuroscience. Many survivors of narcissistic abuse have noted that social media feels like their childhood home—the same unpredictability, the same hunger for approval, the same hypervigilance about how they’re being perceived. This research confirms that intuition: the brain responds to social media’s variable rewards the same way it responds to an unpredictable parent. You’re not imagining the parallel.
The damage mechanism is the same. Intermittent reinforcement—unpredictable alternation of reward and punishment—is what makes trauma bonds so powerful and narcissistic abuse so hard to escape. Social media platforms use the identical mechanism: variable rewards explicitly designed to maximise engagement. Understanding that your brain was shaped by one form of intermittent reinforcement (abusive parent) may help you recognise vulnerability to another (algorithmic feeds).
Your children may be experiencing a technological version of what you survived. If you were raised by a narcissistic parent, you know what chronic social unpredictability does to a developing brain. This research suggests your children may be getting a dose of the same thing from their phones—not as severe, but more pervasive. Your experience gives you insight into what they’re experiencing and why reducing habitual checking matters.
Recovery from social media overuse and recovery from abuse may overlap. The same neural regions affected by habitual checking are affected by early relational trauma. Interventions that help one may help the other: building tolerance for uncertainty, reducing compulsive checking of external validation, developing internal sources of worth. Your work on healing from abuse may protect you from digital versions of the same patterns.
Clinical Implications
Assess checking frequency specifically, not just screen time. This study identifies habitual checking—the compulsive, frequent pattern—as the risk factor, not total time spent on social media. A patient who spends two hours scrolling once daily is different from one who checks for three minutes every ten minutes. Assessment should capture the intermittent pattern that this research links to neural changes.
Consider social media reduction as treatment for anxiety and depression. The neural regions sensitised by habitual checking overlap substantially with those implicated in anxiety disorders. Reducing checking behavior may be a legitimate treatment component, not just lifestyle advice. Frame it neurobiologically: the patient’s brain has adapted to constant social monitoring; reducing the behavior allows the brain to recalibrate.
Use this research for psychoeducation with adolescents and parents. Adolescents may be more motivated to change behavior when they understand their brain is physically changing in response to their habits. Parents may be more willing to set boundaries when they understand the neurobiological stakes. The fMRI images from studies like this make abstract concerns concrete.
Expect withdrawal effects and plan for them. The same neural systems that make checking compulsive make stopping uncomfortable. Patients reducing social media use may experience increased anxiety, social fear, and urges to check. This isn’t failure—it’s the brain expecting the input it’s been trained to need. Planning for this withdrawal and normalising it may improve adherence.
Broader Implications
Platform Design as Public Health Issue
If social media platforms are literally reshaping adolescent brains in ways that increase anxiety and social sensitivity, platform design becomes a public health issue comparable to tobacco or lead exposure. The variable reward schedules that maximise engagement are the same mechanisms causing neural harm. Regulation requiring less addictive design—like limiting notifications or removing visible like counts—has neurobiological justification.
School Policies on Phone Use
Schools that restrict phone use during the school day aren’t just reducing distraction—they may be protecting developing brains from constant social vigilance. This research supports phone-free policies, particularly during developmentally sensitive periods. Every hour without checking is an hour the brain isn’t being trained toward hypervigilance.
Parenting in the Digital Age
Parents of adolescents face a difficult choice: restrict phone use and risk social isolation, or permit it and risk neural changes documented by this research. The study suggests a middle path: not eliminating phones but reducing the habitual checking pattern specifically. This means addressing notifications, app design, and social norms around constant availability.
The Attention Economy’s Collateral Damage
Maza’s research quantifies what attention economy critics have long suspected: platforms optimised to maximise engagement are optimised to produce neural changes in users. The business model depends on habitual checking; the habitual checking produces brain changes. This externality is currently unpriced and unregulated—the platforms profit while users bear the neural cost.
Intergenerational Considerations
Parents whose own brains were shaped by early relational trauma may be raising children whose brains are being shaped by technological trauma. The specific content differs, but the mechanism—chronic unpredictable social feedback producing hypervigilant neural development—is the same. Understanding this parallel may help parents recognize in their children’s relationship with phones echoes of their own relationship with their parents.
Research and Clinical Training
Clinicians trained before the smartphone era may not recognize the neural significance of social media habits. This research suggests that social media assessment should be standard in adolescent mental health practice, and that interventions targeting phone use may be as important as traditional psychotherapy for some patients. Training and continuing education should reflect this.
Limitations and Considerations
Correlation doesn’t establish mechanism. While the longitudinal design establishes that checking predicts neural change (not the reverse), the study doesn’t explain how checking produces these changes. The proposed mechanism—brain adaptation to unpredictable social feedback—is plausible but not directly tested.
The sample has limitations. 169 adolescents from one geographic area may not generalize to all populations. Socioeconomic, cultural, and individual factors may moderate effects. The findings require replication across diverse samples.
“Habitual checking” is self-reported. Adolescents estimated their checking frequency, introducing potential recall bias and social desirability effects. Objective measurement (e.g., phone tracking data) would strengthen conclusions.
Clinical significance is uncertain. Statistical significance doesn’t equal clinical significance. Whether these neural changes translate to meaningful differences in mental health, relationships, or functioning remains to be established. The changes might be adaptive without being pathological.
Historical Context
This study appeared in January 2023, representing a methodological breakthrough in research on social media and the brain. Previous neuroimaging studies were cross-sectional—measuring brain differences at a single time point—which couldn’t establish causation. Did social media cause brain differences, or did pre-existing brain differences lead to more social media use?
Maza and colleagues’ three-year longitudinal design with repeated fMRI scanning addressed this fundamental limitation. By showing that checking behavior at time 1 predicted neural changes at times 2 and 3, they established temporal precedence—a key criterion for causal inference.
The publication venue (JAMA Pediatrics) and the strength of the findings generated substantial media attention and policy discussion, contributing to growing momentum for adolescent social media regulation.
Further Reading
- Telzer, E.H. et al. (2018). Methodological considerations for developmental longitudinal fMRI research. Developmental Cognitive Neuroscience, 33, 149-160.
- Orben, A. & Przybylski, A.K. (2019). The association between adolescent well-being and digital technology use. Nature Human Behaviour, 3(2), 173-182.
- Twenge, J.M. et al. (2018). Increases in depressive symptoms, suicide-related outcomes, and suicide rates among U.S. adolescents after 2010. Clinical Psychological Science, 6(1), 3-17.
- Alter, A. (2017). Irresistible: The Rise of Addictive Technology and the Business of Keeping Us Hooked. Penguin.
- Haidt, J. & Twenge, J.M. (2023). Social media and mental health: A collaborative review. Unpublished manuscript, NYU.
Abstract
This three-year longitudinal fMRI study followed 169 adolescents to examine how habitual social media checking behaviors relate to functional brain development. Adolescents who habitually checked social media showed increasing activation in the amygdala and anterior insula during social anticipation tasks, while non-habitual checkers showed decreasing activation. These findings suggest that habitual social media checking during adolescence may be associated with changes in how the brain responds to social feedback, with potential implications for mental health.
About the Author
Eva H. Telzer is Professor of Psychology and Neuroscience at the University of North Carolina at Chapel Hill, where she directs the Developmental Social Neuroscience Lab.
Telzer earned her PhD from UCLA and completed a postdoctoral fellowship at the University of Illinois. Her research uses neuroimaging to understand how the adolescent brain develops within social contexts, with particular focus on how family relationships and peer experiences shape neural development.
This study represents a methodological advance: previous research on social media and the brain was cross-sectional (single time point), making causation impossible to determine. Telzer's three-year longitudinal design with repeated fMRI scanning allows causal inference that was previously unavailable.
Historical Context
Published in January 2023 in JAMA Pediatrics, this study arrived at a critical moment in debates about social media's effects on adolescents. Previous research had established correlations between social media use and mental health problems, but critics argued correlation doesn't prove causation. Maza et al.'s longitudinal design addressed this critique directly, demonstrating that habitual checking precedes and predicts neural changes—not the reverse.
Frequently Asked Questions
Yes—and that's actually not surprising, because everything changes the brain. The question is whether these specific changes are harmful. This study shows that habitual social media checking sensitises the brain regions involved in processing social threat and reward. These are the same regions that become hyperreactive in anxiety disorders and in children raised in unpredictable environments. The changes aren't inherently pathological, but they represent the brain adapting to an environment of constant social monitoring—which may not serve adolescents well.
The study shows the brain changing over three years, not that changes are permanent. Adolescent brains are highly plastic—that's why they're vulnerable to these effects, but also why recovery is possible. However, we don't yet have longitudinal data on what happens when habitual checking stops. The same neuroplasticity that allows social media to reshape the brain should allow it to re-normalize with changed behaviour, but the specific timeline and completeness of recovery remain unknown.
Because both create chronic unpredictable social feedback that the brain must constantly monitor. A child of a narcissistic parent never knows if they'll receive love or rage, so the amygdala becomes hypersensitive to social cues. Social media creates identical uncertainty: Will this post get likes? Will I be criticized? The brain doesn't distinguish between parents and platforms—it just learns that social outcomes are unpredictable and require constant vigilance.
The research supports reducing habitual checking specifically, not necessarily eliminating all phone use. The concern is the compulsive, frequent checking pattern—not occasional use. Consider interventions that reduce the unpredictable reward cycle: turning off notifications, setting specific times for checking, using apps that batch notifications. Complete phone removal may backfire socially and create its own stresses. The goal is reducing the intermittent reinforcement pattern, not digital isolation.
First, assess social media habits specifically—frequency of checking, not just total screen time. Habitual checking is the risk factor this study identifies. Second, consider social media reduction as part of treatment for anxiety and depression, given the neural overlap with these conditions. Third, use this research psychoeducationally: adolescents may be more motivated to change when they understand their brain is physically adapting to the checking behavior. Fourth, monitor for withdrawal effects—the same systems that make checking compulsive make stopping uncomfortable.
The study specifically examined adolescents, whose brains are more plastic than adults'. Adult brains are less susceptible to rapid restructuring, so the effects might be smaller or slower in adults. However, the underlying mechanism—the brain adapting to an environment of unpredictable social feedback—likely operates at any age, just with different magnitude. Adults who developed social media habits during adolescence may already have these neural patterns established.
The implications are concerning but not deterministic. A generation with more sensitised threat-detection systems may experience higher baseline anxiety, more social comparison, more sensitivity to rejection. But brains also adapt to changed environments, and cultural awareness of these effects is growing. The research argues for systemic changes—platform design, school policies, parenting practices—not just individual interventions. Population-level problems require population-level solutions.
Major unknowns include: Do these neural changes predict later psychopathology, or are they adaptive without being pathological? What happens when habitual checking stops—do the changes reverse? Are some adolescents more vulnerable than others based on genetics or prior experience? What specific features of social media (notifications, likes, comments, content) drive the effects? And critically—what interventions effectively reduce habitual checking while maintaining the social benefits adolescents get from these platforms?