TikTok in adolescence: Is it impacting the health of a generation?

There is a recent controversy about the influence and use of social media among children and young people. What are the biggest dangers and opportunities?

International Youth Day

12 August marks the International Youth Day. The day focuses on the situation and concerns of children and young people worldwide.

Interpersonal contact: only filtered through screens?

Again and again, you see small children with a mobile phone or a tablet in front of them. The parents themselves usually stare spellbound at the small screen of their mobile phone. One could think that the modern style of education is only carried out through the consumption of digital content. The impact this is having on our society can be seen in different areas of everyday life.

Pedestrians cross the street without taking their eyes off their smartphones, and others are hardly noticed. Some have the feeling that society is slowly depleting its cognitive capacities and interpersonal contacts are only filtered through screens. Only time will tell what long-term consequences this trend will have on future generations.

TikTok as a public health communication channel

TikTok is one of the fastest growing social media platforms among children and adolescents worldwide. Until now, there has been little research into the use of this app from the psychology and psychiatry side. A research group from Ireland wanted to find something positive about this social media, and conducted a systematic review of studies to investigate whether this platform can be used as a communication channel for public health.

In itself, the ubiquitous use of social media around the world provides an ideal platform for disseminating public and mental health information to children and young people. Among children and adolescents, the currently popular social networks represent an immensely important digital health resource. The otherwise hard-to-reach 13-29 year olds can thus be educated about health issues directly in their digital element.2

What is TikTok?

TikTok is a video-based social media app that allows its users to consume short videos (approx. 15-60 seconds long) or create them themselves. A variety of filters, music and lip-sync templates are used. Users receive their digital input through an algorithm. The algorithm is based on the stated preferences and previously liked content. Globally, the majority of TikTok users are in adolescence.2

One danger of algorithm-driven consumption is confirmation bias and drifting into a rabbit hole. The Corona pandemic has shown us how quickly this can happen to certain groups of adults via Telegram. Opinions are placed above scientific data because chat group members or, in the case of TikTok, the algorithm underpins them.

How can children and young people be reached via TikTok?

The Irish research group attempted to find a positive use of TikTok: targeted communication with children and young people would be possible, for example, by linking health topics via a short video sequence and the appropriate hashtag. There have already been waves of information on TikTok about COVID-19, mental health, eating disorders, developmental problems, and health. Psychologist Dr Julie Smith is already using TikTok as a platform to spread psychoeducational content, and with success: her TikTok profile has a whopping 33.4 million likes and over 2.9 million followers.

Especially in times of a shortage of psychology professionals, and a simultaneous increase in mental illness among crisis-stricken children and adolescents, this opportunity to share information digitally can save lives - in her videos, Dr Smith also addresses topics such as anxiety and suicidality.2 Children and adolescents have only been able to use their smartphones for social interaction with peers during the Corona pandemic, in which the incidence of mental illness increased.

The addictive potential of the video-based social media app is real

A recently published study reveals the darker side of TikTok use. The study investigated a link between short video app use and psychosocial factors in a total of 1,346 adolescents. The majority of the study participants were female (51.8%). Of the 1,346 study participants, 686 were moderate users, 461 were addicted users, and 199 were non-users. Addicted users were found to have poorer mental health overall - compared to those who did not use TikTok. Mental health status among addicted users was characterised by:

Addicted users had higher levels of academic stress with poorer academic performance. They were often victims of bullying and had poorer parental relationships. Also, a negative parenting style and lower parental education level were present in addicted users. Moderate users showed no differences in mental health or academic performance compared to non-users of the TikTok app.3

References:
  1. Flynn HC. et al. (2022). Social Media and Adolescent Mental Health: Sounding the Alarm. NASN Sch Nurse. 2022 Sep;37(5):271-276. 
  2. McCashin D. et al. (2023). Using TikTok for public and youth mental health - A systematic review and content analysis. Clin Child Psychol Psychiatry. 2023 Jan;28(1):279-306. 
  3. Chao M. et al. (2023). TikTok use and psychosocial factors among adolescents: Comparisons of non-users, moderate users, and addictive users. Psychiatry Res. 2023 Jul;325:115247. 
  4. Zheluk AA. et al. (2022). Adolescent Anxiety and TikTok: An Exploratory Study. Cureus. 2022 Dec 14;14(12):e32530.