Virginia has joined a nationwide investigation into the physical and mental health impacts of TikTok on children and young adults, Attorney General Jason Miyares announced earlier this month.
While the popular app - which now has nearly a billion users - may seem harmless on the surface, its potentially negative impacts have recently attracted the attention of almost every attorney general in the nation.
Top legal officers joining the multistate effort want to know if TikTok has violated consumer protection laws and "put the public at risk." They're also investigating concerns that the company is aware of the harm it can cause to young people yet uses questionable tactics to increase the amount of time kids and teens spend on the app.
“Virginia has officially joined a bipartisan, nationwide investigation into TikTok’s platform and its effect on the mental and physical health of kids and young people," Miyares said in a news release. "Our children are in the midst of a mental health crisis, and the negative effects of social media platforms like TikTok on our youth have raised concerns for some time."
Several experts told The Triangle there are valid reasons for the concerns surrounding TikTok use among children and teens. They say that while the app can indeed provide lighthearted entertainment, it also has the potential to be destructive.
According to Anjali Gowda Ferguson, Clinical Psychologist at the Children's Hospital of Richmond at VCU, TikTok "can have both positive and negative impacts on children and adolescent mental health," like many other social media outlets.
But of particular concern is the potential for the platform to foster cyberbullying, which, she says, can "lead to depression, anxiety, body dysmorphia and social withdrawal” – all potentially serious conditions that may require parental intervention.
“Given that children and adolescents are still developing self-regulation and appraisals of risk and/or harm, all social media use, including use of TikTok, should be supervised by a caregiver to ensure a child is engaging in safe practices,” Ferguson said.
Ferguson’s views were echoed by Rebeccah McCully, Resident in Counseling with ThriveWorks, a Virginia-based mental health and therapy company.
McCully said that while the app – which is well-known for its fun dance videos – is understandably appealing to young people, it also has a darker side.
"I have worked with many teens who have been victims of cyberbullying, whether it is where a peer has set up a TikTok live in a bathroom of school, a reel is made making fun of them or telling the child/teen the world is better off without them or a friend has recorded them in a vulnerable circumstance,” McCully said. “If not closely monitored, cyberbullying could occur, or even worse, [the child or teen] could be talking to who they think is a friend but is actually a child predator."
A BBC Panorama investigation confirmed that McCully’s worries about predators targeting kids through the app have merit.
TikTok has been slow to take action against adults who use the platform to engage children in sexually explicit conversations, even when those conversations are flagged by users.
For the network's investigation, a 24-year-old journalist created a mock account of a 14-year-old girl. The account was quickly followed by older men who attempted to initiate sexual interactions with the girl, even after the woman said she was only 14.
Posing as the girl, the journalist then reported one of the predatory users to TikTok. But the company failed to take action until it was contacted directly by the BBC and provided with the details of the investigation.
A TikTok spokesperson initially defended the company’s failure to intervene, stating, “A report about a user’s account or comments will not generally trigger a review of direct messages."
Amid mounting pressure, though, the company later banned the accounts of two of the men who had committed the violation and released a follow-up statement, saying the company is actively working with industry experts, NGOs and online safety specialists to "continuously strengthen safety on TikTok."
Nonetheless, the ongoing BBC analysis continued to dig up disturbing details.
Researchers involved in the investigation spoke to one former content moderator who was charged with the task of making sure users complied with the app's Terms of Service. The former employee said the company's Beijing-based headquarters was reluctant to suspend accounts or take action against users who abused the system.
"They would pretty much only ever get a temporary ban of some form, like a week or something," he told BBC Panorama.
The former employee also said the moderators on his team were not granted the ability to ban accounts, and, as a result, they often felt “powerless” to stop predators.
In addition, BBC Panorama researchers found that the app’s mechanisms may also further feed predatory behavior. If an adult seeks out sexually suggestive content of underage kids, the app will continue to locate and recommend similar videos for that user, the investigation determined.
Some Kids are Using TikTok to Self-Diagnose
John F. Tholen, a retired clinical psychologist and author of the book, Focused Positivity: The Path to Success and Peace of Mind, argues that one of the more under-recognized possible dangers of TikTok is the fact that an alarming number of young people are using it to self-diagnose.
"Self-diagnosis of mental health conditions based on information found on social media sites such as TikTok has become widespread during the COVID pandemic," Tholen said.
Tholen believes there are three primary factors contributing to this concerning trend.
First, he cited studies showing that American teens are spending a staggering 9 hours per day, on average, on social media, leading them to become heavily impacted by "influencers" and other app users who may share information about their own medical conditions.
Secondly, he says the adolescent brain is still physically and emotionally maturing. As a result, teens are much more impressionable than adults and are more likely to try to imitate influencers and other peers they interact with on the platform.
Finally, Tholen argues that isolation spurred by Covid-19, educational delays and other pandemic-related losses are placing "understandable stress" on teens, causing them to turn to social media apps like TikTok in an effort to understand the way they’re feeling. In most cases, he said, they should instead be discussing their concerns with their parents or an appropriate medical professional.
Tholen also stressed that social media diagnoses can be dangerous because they're “frequently incorrect and can have a long-lasting impact on our self-image.”
A recent report by Good Morning America supported Tholen's assertions: investigators found that videos on TikTok are causing some users to diagnose themselves with "rare mental health disorders that they probably don't have."
Posts with the hashtag #dissociativeidentydisorder, for instance, were viewed hundreds of millions of times, with some of those videos listing possible symptoms of the condition and encouraging viewers to self-evaluate.
Nonetheless, dissociative identity disorder is considered to be a very rare condition, affecting only between 0.01 and 1% of the population, according to Cleveland Clinic.
Finding Balance - and Looking Out for Red Flags
Ferguson said that while there are risks connected to the use of TikTok, young people can also benefit from using social media. The key is finding the right balance and ensuring kids' use of the platform is monitored.
"Social media use has also been related to positive outcomes in youth to include socialization, enhanced communication, awareness of diverse perspectives, community engagement and connection," Ferguson said.
"From a culturally responsive perspective, social media can offer a child or adolescent access to like-minded individuals and communities that may not be represented in their physical environments. This affords opportunities to build cultural pride, which is a known protective factor for minoritized youth,” she added.
Still, Ferguson and McCully stressed that parents need to look out for warning signs that suggest their child or teen is suffering from negative mental health impacts related to TikTok use.
Ferguson said parents who are concerned their child is suffering from negative impacts caused by the platform should pay attention to any changes in mood or behavior. This can include "withdrawal or preoccupation," where it may be difficult to keep them away from the app.
Parents should also familiarize themselves with the platform so they know how to use it and can intervene if necessary.
"Keep communication channels open so that your child/teen feels safe coming to you with any distressing content they encounter on the app. Allow them opportunities to discuss their thoughts and experiences without judgment," Ferguson advised.
Additionally, Ferguson and McCully both emphasized that parents should be alert for changes in their child's daily functioning, such as reductions in school performance, sleep or appetite and changes in mood.
In those cases, "it may be a good idea to connect with a mental health professional for additional support," Ferguson said.
📧 Have questions, comments or suggestions? Want to submit an event for consideration? Please send me an email or reply to this newsletter.