{"doi":"10.1101/2021.09.08.21263218","title":"The phenomenology of tics and tic-like behavior in TikTok","abstract":"ABSTRACT Background and Objective Pediatricians and pediatric subspecialists worldwide have reported a marked increase in functional (conversion) disorders with tic-like behaviors during the COVID-19 pandemic. These patients often report frequent viewing of Tourette Syndrome (TS) TikTok videos, suggesting disease modeling. We aimed to evaluate tic phenomenology in videos posted on TikTok. Methods The 100 most-viewed videos under #tourettes in TikTok were randomly assigned to two primary reviewers (n=3; <2 years independent practice), all pediatric neurologists specializing in movement disorders, for extraction and classification of tic phenomenology. Initial disagreements were solved by consensus. If not resolved, a senior reviewer (n=5; >2 years independent pediatric movement-disorder practice) served as tiebreaker. In addition, two primary and one senior reviewer rated each video on a Likert scale from 1= “All the tics are typical of TS” to 5= “None of the tics are typical of TS”. Mean scores and Spearman correlation between primary and senior reviewers were calculated. Results Six videos without tic-like behaviors were excluded. Most videos depicted coprophenomena (coprolalia: 53.2%; copropraxia: 20.2%), often with unusual characteristics. Frequently, videos demonstrated atypical phenomenology such as very strong influence by the environment (motor: 54.3%; phonic: 54.3%), aggression (19.1%), throwing objects (22.3%), self-injurious behaviors (27.7%), and long phrases (>3 words; 45.7%). Most videos portrayed atypical, non-tic behaviors (Median [IQR] Likert ratings: Primary 4.5 [4-5]; Senior 5 [3-5]). Primary vs. senior rater scores demonstrated moderate agreement (r = 0.46; p<0.001). Conclusions TS symptoms portrayals on highly-viewed TikTok videos are predominantly not representative or typical of TS. Highlights Many teenagers with functional tic-like disorder have been reported during the COVID-19 pandemic. These patients report increased viewing of Tourette Syndrome TikTok videos, a popular social media platform, and present with similar tic-like behaviors. Current TikTok videos are poorly representative of Tourette syndrome and more consistent with functional tic-like behavior. We provide a detailed description of the phenomenology tics and tic-like behavior portrayed in TikTok.","journal":"medRxiv","year":2021,"id":214426,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":10,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9314,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":713012,"name":"Adrienne Bruce","orcid":"0000-0003-2823-1356","position":1,"is_corresponding":false},{"id":807880,"name":"Jordan Garris","orcid":"0000-0001-7940-5139","position":2,"is_corresponding":false},{"id":787966,"name":"Laura Tochen","orcid":"0000-0001-8174-6338","position":3,"is_corresponding":false},{"id":808481,"name":"Poonam Bhatia","orcid":null,"position":4,"is_corresponding":false},{"id":808482,"name":"Rebecca Lehman","orcid":null,"position":5,"is_corresponding":false},{"id":807881,"name":"Wendi L. Lopez","orcid":"0000-0002-7287-8651","position":6,"is_corresponding":false},{"id":713013,"name":"Steve W. Wu","orcid":"0000-0001-5102-174X","position":7,"is_corresponding":false},{"id":106044,"name":"Donald L. Gilbert","orcid":"0000-0002-9245-6878","position":8,"is_corresponding":false},{"id":807879,"name":"Alonso Zea Vera","orcid":"0000-0002-8172-3117","position":0,"is_corresponding":true}],"reference_count":40,"raw_metadata":null,"created_at":"2026-07-18T23:52:46.604690Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}