The Reinforcement Effect of Social Media Likes in Depression

Importance: There is growing concern about the impact of social media on mental health. Understanding the psychological processes underlying social media use could lead to greater insight. Objective: To investigate individual differences in the effect of social media likes on posting behavior and their association with and specificity to depressive psychopathology. Design, Setting, and Participants: This cross-sectional study used longitudinal Twitter behavior to test the association between depressive and other forms of psychopathology and the tendency to be reinforced by likes. The study involved passively scraped Twitter data (dataset 1) or participants recruited online through Twitter ads (dataset 2) and a recruitment platform (dataset 3). In total, the 3 datasets contained over 17 million posts from 7736 Twitter users. These data were analyzed from March 2023 through January 2026. Main Outcomes and Measures: Reinforcement tendency was estimated as the association between previous-day likes and current-day posting. The depression measure varied between datasets: self-disclosure in dataset 1, past 4-week depression severity in dataset 2, and a validated questionnaire in dataset 3. Dataset 3 also included other psychiatric measures used to estimate scores on transdiagnostic symptom scores. Results: Dataset 1 comprised 1045 users who reported a depression diagnosis on Twitter, and 5001 randomly sampled users. Dataset 2 comprised 601 users (mean [range] age, 45.2 years [18-78]; 251 [41.7%] women, 333 [55.5%] men, and 17 [2.8%] individuals with other gender identities). Dataset 3 comprised 1089 users (mean [range] age, 30.8 years [18-68]; 703 [64.6%] women, 358 [32.8%] men, and 28 [2.6%] individuals with other gender identities). Individuals with a depression diagnosis or higher symptoms of depression tended more to be reinforced by likes in all datasets (dataset 1: β = .013; P = .002; dataset 2: β = .026; P = .03; dataset 3 [preregistered]: β = .008, P = .02), despite substantial differences between datasets in depression measurement and composition. In dataset 3, greater reinforcement tendency was specifically associated with a transdiagnostic anxious-depression factor, whereas behavioral persistence was linked to a compulsivity and intrusive thought factor. Conclusions and Relevance: In this study, depressive psychopathology was associated with a greater tendency to be reinforced by a type of social reward on Twitter, in contrast to typical laboratory-based findings of blunted reinforcement learning in depression. These findings suggest potential mechanisms linking social media use to worse mental health or vice versa, and emphasize the importance of studying real-world behavior.