academic.oup.com
In Germany, the current outbreak of mass social media-induced illness is initiated by a ‘virtual’ index case, who is the second most successful YouTube creator in Germany and enjoys enormous popularity among young people. Affected teenagers present with similar or identical functional ‘Tourette-like’ behaviours, which can be clearly differentiated from tics in Tourette syndrome.
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patients often reported to be unable to perform unpleasant tasks because of their symptoms resulting in release from obligations at school and home, while symptoms temporarily completely disappear while conducting favourite activities.
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Rather than these teens being denied a Tourette's diagnosis, it seems more likely to me that the practical definition of Tourette's (or "Tourette's like [blah blah blah]", whatever makes them feel satisfied that they've been "heard" and can brag to their online friends about an official diagnosis) will just expand to include people like them. Anything else would run the severe risk of being attacked by a mob of the usual advocates of "disability rights", "social justice", etc.
Conversely, with the general understanding evolving to be that most tics are semi-conscious/chosen, we can expect those with genuinely involuntarily but controversial tics such as those involving repeating racial slurs, etc. to become more stigmatized (in the name of rights for the "disabled", that is other people half-pantomiming their actual illness), similarly to how the "Mental illness isn't an excuse for racism!" canard evolved (after you had thousands of people (primarily self-diagnosed) allegedly possessing X mental illness around to say "Well I also have [X] and it's never caused me to say [non-PC thing]!").
On the other hand, I think the line between performance and authenticity has always been a lot blurrier than many would like to believe. Perhaps the pseudonymous and polyonymous nature of the Internet has just made this a more practically implementable tendency, increasing its behavioral potency. As with most fads, this particular manifestation of it will probably wax and wane though, same as all fashion (and isn't all fashion inherently performance desperately grasping for authenticity?). (I for one am waiting for wheelchairs, colostomy bags, etc. to become in many cases voluntary fashion accessories.)
Are you willing to make a concrete testable prediction of this, like say putting a probability on a particular modification to the definition in a given future DSM revision?
Okay, I'll try:
90% certainty: For as long as this trend continues, the number of official diagnoses of anything Tourette's-related that officially deem the involved symptoms to be caused by a sociogenic component, social contagion, social media etc. will not rise above 50% even solely amongst cases that don't fit traditional diagnostic criteria. They may get a diagnosis of "Tourette's-like functional movement disorder" or whatever instead of the real deal from more cautious docs but they won't get "You're larping this because of social media." The vast majority of providers won't touch that because why give your customer what they explicitly don't want?
To be clear I think it's likely that the actual hard definition of Tourette's will remain mostly unchanged (and articles like the OP's will continue to bemoan the conflation of fully involuntary tics with their more voluntary counterparts), but the actual practical definition in the field will become much more porous based on consumer demand. Diagnostic criteria, like all words on paper, only matter if they're followed. So I wouldn't expect to see the words on the paper describing Tourette's change necessarily, but I would expect to see it become more and more normalized for people who don't exactly fit those words to nevertheless be deemed as defined by them regardless (maybe that's not changing the definition per se, depends on your point of view about ontology).
Do doctors in Germany have "customers"?
I'm assuming they're subjected to patient evaluation to some degree. Surely people in Germany can at least indicate their wish to no longer see a particular doctor, public healthcare or not.
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