Recruiting

Trigger Warnings

Sponsor:

Sunnybrook Health Sciences Centre

Code:

NCT07913854

Conditions

Suicide Prevention

Social Media Users

Eligibility Criteria

Sex: All

Age: 14 - 19

Healthy Volunteers: Not accepted

Interventions

Trigger Warning

Study Details

Brief summary:

Rates of suicide among Canadian youth have risen steadily over the past two decades, alongside rapid growth in social media use-especially TikTok. Our research shows that TikTok contains substantial suicide-related content that may pose risks to vulnerable young people by provoking distress or encouraging copycat behaviour. Many creators add trigger warnings (TWs) to flag upsetting material, yet their impact is unclear. Although research shows mixed effects of TWs among people with trauma histories, no studies have examined TWs in the context of suicide-related content. Our recent findings indicate that TWs are associated with reduced engagement suicide-related videos on TikTok-contrary to our hypothesis that they might increase engagement. Although we can only speculate, reduced engagement may reflect youth avoiding TW-labelled content, or other unknown factors. This study will examine how a clinical population of youth at risk of suicide emotionally and behaviourally respond to TWs on self-harm and suicide-related content. Findings will provide key evidence to inform public health recommendations aimed at protecting youth from harmful content online.

Conditions

Suicide Prevention

Social Media Users

Study ID

NCT07913854

Start date

Nov 15, 2026

Status verified date

Oct, 2026

Completion date

Dec 15, 2027

Anticipated

Primary completion date

Aug 15, 2027

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 14 - 19

Healthy Volunteers: Not accepted

Inclusion Criteria:

  • Lifetime or recent suicidal thoughts as measured on the Columbia Suicide Severity Rating Scale (C-SSRS)20 screening version. Defined as answering "YES" Question 2 on the C-SSRS with a lifetime and/or past month time-framing ("In your entire life, have you ever had any thoughts of killing yourself?" and/or "In the past month, have you had any thoughts of killing yourself?")
  • Self-identified consumer of short-form content on social media (e.g. Instagram reels, TikTok, YouTube Shorts) in the last year.
  • English comprehension

Exclusion Criteria:

  • Suicidal ideation with any intent or plan in the last 6 months. Defined as answering "YES" on any one C-SSRS Question 3 to 5 with a past 6-months timeframe. Note: Suicidal ideation in the absence of intent or planning is not an exclusion criterion
  • Suicidal behaviour in the last 6 months. Defined as answering "YES" to C-SSRS Question 6 ("In your entire life, have you ever done anything, started to do anything, or prepared to do anything to end your life?") AND a 6-months follow up questions ("Was this within the past 6 months?"). Note: Lifetime suicidal behaviour (i.e. answering yes to only Question 6) is not an exclusion criterion
  • In active psychosis or mania, as indicated by patient's medical records

Study Design

Enrollment

82 participants

Anticipated

Allocation

Randomized

Intervention Model

Parallel Assignment

Primary purpose

Prevention

Interventions and Outcome Measures

Arms

experimental: TW+: Trigger warning before suicide-related videos

In this arm, participants will view a Trigger Warning (TW: Suicide) before the suicide-related content (one male -presenting and one female-presenting).

no intervention: TW-: No Trigger Warning

In this arm participants will not view a Trigger Warning before watching the suicide-related content (one male-presenting and one female-presenting).

Interventions

Trigger Warning

The intervention will be the presence of a Trigger Warning (i.e., TW: Suicide) at the start of two suicide-related videos. One video will be of a male-presenting creator, and the other of a female-presenting. Both videos are recovery centered, but neutral, therefore not overally hoepful/postive, but not negative. We hypothesize that the presence of a Trigger Warning will affect emotional and behavioral responses to the suicide-related content.

Primary outcome measure

  • Emotional Affect [ Time Frame: Administered to both study groups immediately before and immediately after viewing both videos. ]

Central Contacts and Locations

Central contacts

Zoe Shelton, B.A.

4388703910zoejacklyn.shelton@mail.utoronto.ca

Caroline Milligan, H.BSc

416-347-9622caroline.milligan@sunnybrook.ca

Locations

Sunnybrook Health Sciences Center

Recruiting

Toronto, Ontario, Canada, M4N 3M5

Contacts

Zoe Shelton, B.A.

4388703910zoejacklyn.shelton@mail.utoronto.ca

Caroline Milligan, H.BSc

416-347-9622caroline.milligan@sunnybrook.ca

Principal Investigator:

Rachel Mitchell, MD, MSc

More Information

Sponsor

Sunnybrook Health Sciences Centre

Last update posted

Nov 3, 2026

Last verified

Oct, 2026

Keywords

  • Create Guidelines and Best Practices
  • Mental Health
  • Youth Mental Health
  • Suicide
  • Social Media
  • Trigger Warnings

Trial information was received from ClinicalTrials.gov and was last updated on 2026-11-04. This information was provided to ClinicalTrials.gov by Sunnybrook Health Sciences Centre on 2026-11-03. Recruitment status is synced daily from ClinicalTrials.gov and may not reflect the sponsor's current status. Confirm during your call.