TikTok, the rapidly growing social media platform popular among children and young people worldwide, remains surprisingly under-researched in psychology and psychiatry, according to a two-part study. Despite concerns about the potential effects of social media on youth mental health, there has been limited academic exploration of TikTok’s impact.
In the first part of the study, researchers conducted a systematic review of studies related to TikTok and its association with public health or mental health from 2016 to 2021. They searched six databases and identified 24 studies covering various topics, including COVID-19, dermatology, eating disorders, and public health promotion. Most of these studies were from the USA and used content analysis as their research method.
In the second part of the study, the researchers analyzed 29 Irish TikTok accounts, including those of public health authorities, charities, and personal TikTok creators. These accounts collectively garnered significant engagement from younger populations, with a total of over 2.5 million likes, 13,775 comments, and 21,254 shares.
Study 1 – Systematic Review
Search Strategy: The research team developed a comprehensive search strategy that included relevant public and mental health terms combined with the keyword “TikTok.” This strategy was applied to six databases, namely PSYCINFO, PUBMED, Wiley, Journal of Medical Internet Research (JMIR), covering the period from 2016 to 2021. The detailed search strategy is available in the supplementary materials.
Search Timeline: The search was conducted between June and July 2021, resulting in the screening of 275 studies initially.
Selection Criteria and Quality Appraisal: Studies that were included had to be published in English and focus primarily on TikTok. For quantitative studies, the team used the quality appraisal tool by Dunne et al. (2018), while qualitative studies were assessed using the CASP (2018) checklist. The second author conducted the initial screening of titles and abstracts, with both authors discussing and reaching a consensus on articles with unclear eligibility.
- Number of Studies: A total of 24 studies were included in the final review.
- Geographical Distribution: The majority of these studies were conducted in the USA (20 out of 24), with the remaining studies originating from China, Ireland, Australia, and Canada.
- Research Methodologies: Most of the studies employed content analysis as their primary research methodology (20 out of 24). Other research designs included cross-sectional studies (1), thematic analysis (2), and case series (1).
- Diverse Topics: The research on TikTok covered a wide range of topics, including COVID-19 (10 studies), dermatology (7), eating disorders (1), cancer (1), tics (1), radiology (1), sexual health (1), DNA (1), and public health promotion (1).
- Study Quality: The overall quality of the studies varied, with 11 studies rated as low quality, 7 as acceptable, and 6 as good quality.
Study 2 – Content Analysis on TikTok
Search Strategy and Data Collection: The research team aimed to replicate the search strategy used in Study 1. They converted the search terms into TikTok hashtags and combined them with Irish-specific hashtags. The top two “most liked” videos were selected from three specific groups: official public health accounts, registered Irish charities, and personal TikTok creators. This data collection took place in July 2021, using a research-only TikTok account.
Coding Approach: To centralize and organize the collected information, a descriptive table was created in advance. This table included engagement metrics like the number of likes, followers, and comments, as well as video characteristics, summaries, and duration. The presence of a dialogic loop, where questions were posed and answered to encourage engagement, was considered crucial for TikTok and counted across all included content. Data extraction and synthesis were manually performed by the second author using Microsoft Excel.
- Account Types: The analysis covered various types of TikTok accounts popular in Ireland, including public health accounts (2), charity accounts (5), and personal creator accounts (22).
- Engagement Metrics: The analysis revealed substantial engagement with TikTok content, including 2,588,181 likes, 13,775 comments, and 21,254 shares.
- Account Characteristics: There were notable differences in the characteristics of content across different account types, such as official public health accounts, TikTok personal accounts (creators), and charity accounts.
- Engagement Levels: TikTok creators were found to be the most engaging and interactive, which correlated with their higher number of followers.
- Dialogic Loop: The presence of a dialogic loop, a key engagement measure, was observed across different content and account types.
While TikTok has been utilized for various public health purposes, including mental health awareness, the study highlighted that institutional accounts have not effectively engaged with the platform. The study also found differences in how TikTok accounts used platform features to interact with users.
The researchers emphasized the need for high-quality evaluations of TikTok content’s impact on public and mental health, especially considering its popularity among children and young people. They noted that TikTok presents a unique opportunity for youth mental health practitioners to connect with their target audience, but there is still much to learn about its functionality and effects on mental health.
The study also discussed concerns about the potential negative effects of social media on youth mental health, with TikTok being no exception. However, it highlighted the lack of specific clinical literature on TikTok use and the need for more comprehensive research in this area.
Despite these concerns, TikTok has acknowledged both the positive and negative aspects of its platform and has taken steps to address issues related to user well-being, such as providing resources for users seeking help with suicide-related content.
Overall, these results demonstrate the diversity of research topics related to TikTok and the varying levels of engagement across different types of TikTok accounts in the Irish context.
In conclusion, while TikTok has become a prominent platform for youth engagement, more research is needed to understand its impact on mental health and public health fully. As the platform continues to grow in popularity, addressing these research gaps becomes increasingly important in ensuring the well-being of young users.