Video-based social influencing app TikTok may be grooming young girls to develop Tourettes Syndrome or verbal and motor tics with unusual characteristics, according to medical studies and media reports.
The topic came to the public’s attention in an Oct. 19 article by the Wall Street Journal dubbed Teen Girls Are Developing Tics – Doctors Say TikTok Could Be a Factor, which noted the phenomena had quietly gone viral when a neurologist from the Cincinnati Children’s Hospital Medical Center estimated the number of teens with tics attending at his facility since the pandemic began in March of 2020 being as high as ten per month, up from one per month before the pandemic began.
Professionals from the Texas Children’s Hospital shared similar data, saying they were seeing 60 cases post-pandemic compared to 1 or 2 per year pre-pandemic. Doctors at John Hopkins University and Rush University likewise shared congruent figures.
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Tammy Hedderly, a neurologist in the United Kingdom who leads the Tics and Neurodevelopmental Movement Service at the St. Thomas Hospital in London explained the general symptoms of tics in an April podcast published by the Association for Child and Adolescent Mental Health.
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“If we’re looking at tics we define tics, there are two types,” said Hedderly. “There’s either movements or sounds. So usually called motor or phonic tics. Sometimes vocal, sometimes phonic. These are quite typical movements that are often suggestable. Very brief. They involve different body parts.”
“Traditionally in tic disorders the tics start around the ages of four to six. They start usually around the eyes, blinking, around the face and the head and then often spread down to involve other parts of the body. Overtime they have features, like waxing and waning. So there will be patches where the tics a lot obvious and at other times and quieter periods tics are associated from about the age of eight onwards or nine with a premonitory urge and this is where the children or young people report a build-up of inner sensations, tension or tummy ache or headache or pressing feeling, but then released when the movement or sound occurs.”
In January, Hedderly and two other NHS scientists published a paper examining the link between an increase in tic attacks and the UK’s exceptional lockdown measures. The paper cited a case of a 14-year-old girl who “developed explosive onset of motor and phonic tics” in November of 2020, which they found “occurred the day after the announcement of another COVID-19 lockdown period.”
“The tics mostly occurred in school and resulted in her being sent home. They included complex head turns with neck thrusting and flailing movements of the hands, together with some coprolalia and yelping noises. There was no premonitory urge reported.”
Doctors noted the girl had no childhood history of tics, identified herself as a “shy child,” and that, “There was an associated indifference to the phonic tics without evidence of embarrassment, which is unusual in tic disorders.”
Attendants noted that the teen “admitted to searching various media sites and reading about Tourette disorder and uploading videos of her tics on TikTok.”
The study said that tics and Tourette’s in adolescent girls were quite unusual because, “Typically, childhood tics start around 5–7 years and show a waxing and waning course of predominantly motor tics, more commonly affecting boys in a ratio of 4:1.”
Authors also added, “It is important to note that these young people show little or no response to the usual medications for tics, and we would not recommend prescription.”
The team specifically aired a concern that TikTok’s influence was behind the disorder, “There is some concern that social media and websites such as TikTok that promote the sharing of videos of influencers with symptoms may have a part to play,” noting that the #tourettes tag on the app had 2.5 billion views, which had doubled from January to February.
As of today, the tag has 4.8 billion views.
In their article, WSJ shared medical professionals’ evaluation of the veracity of the videos shown on the Chinese-owned social influencing app, “Many doctors question the stated diagnoses of some Tourette TikTokers and say the behaviors that these mostly-female influencers display in their videos—multiple complex motor and verbal tics—don’t look like Tourette syndrome to them.”
Hedderly’s study continued, “Some teenage girls report increased consumption of such videos prior to symptom onset, while others have posted videos and information about their movements and sounds on social media sites.”
“They report that they gain peer support, recognition and a sense of belonging from this exposure.”
“This attention and support may be inadvertently reinforcing and maintaining symptoms. The role of social media needs further exploration, particularly the potential for ‘contagion’ and the maladaptive gains that might unintentionally arise from this peer identification.”
In her podcast interview, Hedderly also said that “up until recently many children expressing tics really don’t want them and they don’t like them.”
But now, things were different, “They want them to go away and some of the novel presentations we’re seeing at the moment is a certain, in some children as well almost a certain release of enjoyment and relaxation about the tics and some young people are almost laughing about the tics and enjoying them.”
“And that’s an interesting phenomenon that we haven’t come across and we don’t quite understand at the moment,” she said.
When asked about what she believes is causing the appearance of novel tics in adolescent females, Hedderly said that although more research had to be done, she did have a hypothesis: “We are seeing a group of young girls who are telling us from their own stories that they’re using social media, certain websites and viewing certain characters who have become very, very famous.”
“So this is a hypothesis at the moment and I don’t think that this is going to be as simple as something like mimicry or suggestibility directly.”
Hedderly noted that many of the families of the girls presenting with tic symptoms have a “first degree relative with Tourette” or “a sibling with ADHD or a diagnosis of autism spectrum or a family member with autism spectrum and, or even mild neurodevelopmental difficulties that haven’t reached diagnostic cut-off.”
The WSJ chronicled the example of a 17-year-old high school girl in Texas who, after previously being diagnosed with an anxiety disorder and ADHD, began developing tics, which medication was unable to aid, in November of 2020.
The girl was referred to the Texas Children’s Hospital where a specialist asked her about social media use, “She said that during remote school last fall she had a hard time staying organized, and turned to YouTube to find videos of other students with ADHD to see how they were coping.”
The article continued, “That led her to TikTok compilation videos featuring teens with ADHD or anxiety who also had tics. In one of the videos, she recalled, a woman who was baking had such bad tics that she threw eggs against a wall; in another, a girl appeared unable to control her arm movements and hit the people around her.”
The girl’s mother told the Journal, “These kids are trying to find support for anxiety and other things, and they’re going to TikTok and other social media to find help, and it’s coming back to bite them in a terrible, terrible way.”
In a July study by researchers at Rush University titled TikTok Tics: A Pandemic Within a Pandemic, TikTok content creators who used the keywords “tic,” “Tourette,” or “Tourettes” were examined between March 11, 2020 and March 30, 2021 where a “quantitative assessment of TikTok tics” and a “descriptive analysis of the entire series of videos of each content creator” was conducted.
The results found the influencers were an average age of 18.8 years old and the majority are female.
“Unlike the predominance of facial movements in typical tics, arm movements were most frequent. Average tics per minute was 29, and almost all recorded TikTok tics were severe, causing significant disability,” said researchers.
“Whereas coprolalia [involuntary swearing] and self-injurious behavior are only infrequently encountered in typical tic disorders, they were present in the overwhelming majority of TikTok subjects.”
The study’s conclusions were decisive, “TikTok tics are distinct from what is typically seen in patients with Tourette syndrome, although share many characteristics with functional tics.”
“We believe this to be an example of mass sociogenic illness, which involves behaviors, emotions, or conditions spreading spontaneously through a group.”
