Psychological wishful diagnoses on the rise: clinical diagnostics in the wake of social media?
More and more young adults are seeking psychological assessment with preconceived expectations of the diagnosis – or have even already given themselves one. A new study involving 93 clinical psychologists licensed in Austria shows that self-diagnoses and desired diagnoses – often relating to ADHD or autism – are significantly more common today than they were just a few years ago. This is particularly common among young women with higher education and intensive social media use. Some respond to unexpected test results with ‘diagnosis shopping’. Led by Karl Landsteiner Private University (KL Krems), the study examined how this dynamic is changing routine diagnostic consultations – and showed that communication in psychosocial care needs to be refined.
Social media and streaming platforms are now key sources of (mis)information about mental health. Many young people encounter diagnostic terms for the first time on TikTok, Instagram or in TV series. For some, this prompts them to seek help – for others, mental health labels become part of how they describe themselves and present themselves to those around them. Until now, little was known about how professionals assess this development and how it influences everyday diagnostic practice. To clarify this, the Transitional Psychiatry Research Centre at KL Krems surveyed clinical professionals throughout Austria about their experiences with self-diagnoses and desired diagnoses among young adults.
Diagnosis as identity
‘Many young adults today no longer come with an open question such as “What's wrong with me?”’ says Dr Gloria Mittmann, MSc, research assistant at the Transitional Psychiatry Research Centre. ‘They come with a very specific diagnosis in mind, which they have already chosen for themselves – often ADHD or autism – and with a strong desire to have this identity or label confirmed.’ There are understandable reasons for this, according to Mittmann: a formal diagnosis can make everyday stresses seem less like personal failure and more like something that can be named and explained. At the same time, this increases the importance of clarifying the diagnosis. ‘When a diagnosis has become central to one's self-image, any deviation between expectation and clinical assessment can be experienced as deeply threatening,’ she explains.
The survey of professionals shows how widespread this dynamic has become. Most participants reported that self-diagnoses and desired diagnoses were ‘more frequent’ or ‘much more frequent’ than in the past. Only a small minority did not perceive any change, and almost no one observed a decline. ADHD and autism spectrum disorders clearly dominated in both categories, while other disorders were mentioned much less frequently. The respondents described the typical group as primarily female individuals with higher education and intensive use of online media. The most frequently cited motives were relief from feelings of guilt or responsibility, the desire to better understand long-standing difficulties, and the appeal of belonging to a recognised identity group. Access to medication or treatment options, on the other hand, was less frequently cited as a main driver.
Assessment as ‘testing’
he qualitative evaluation shows how strongly expectations shape the diagnostic situation: many respondents described how patients bring with them extensive ‘half-knowledge’ from social media, online self-tests or conversations with those around them. This is often accompanied by a narrow or distorted understanding of diagnostic criteria – and a tendency to quickly pathologise everyday phenomena. In questionnaires and conversations, some answers appeared to be ‘diagnosis-driven’: symptoms that fit the desired label were emphasised – even if the patient's history or third-party reports did not support this picture. In addition, experts reported a low level of openness to alternative explanations.
If the expected diagnosis was not confirmed in the end, strong reactions were the rule rather than the exception – ranging from disappointment and sadness to anger, sharp criticism or ‘diagnosis shopping’, i.e. seeking further clarification until the desired diagnosis is confirmed. In individual cases, specialists reported explicit pressure to change findings or threats of complaints and negative reviews. This makes feedback sessions with those affected all the more important, combining clear professional explanations with a great deal of empathy. ‘Specialists should explain very transparently how a conclusion was reached – and at the same time recognise that for some, the desired diagnosis has become part of their identity history,’ says Mittmann.
Overall, the results point to a broad change: for many young people, diagnoses such as ADHD or autism are no longer just clinical categories, but also social identities that convey belonging and recognition. Clinical practice should respond to this – for example, by systematically addressing self-diagnoses and desired diagnoses in training and continuing education, strengthening skills for providing feedback in high-stakes situations, and encouraging professionals to engage more actively with online mental health cultures.
The study was conducted in collaboration with the Medical University of Vienna and the University Hospital Tulln, a teaching and research location of KL Krems. It fits in with KL Krems' research focus on interdisciplinary fields with high health policy relevance – including mental health and neuroscience – and provides a basis for planning diagnostic services more realistically and protecting diagnostic integrity and patient well-being.
Original publication
Increasing self- and desired psychiatric diagnoses among emerging adults: Mixed-methods insights from clinical psychologists, M. Neumann: V. Steiner-Hofbauer: M. Aigner: A. Höflich: A. Holzinger & G. Mittmann, Int J Clin Health Psychol (2026) 26:100661, doi:10.1016/j.ijchp.2025.100661. https://kris.kl.ac.at/de/publications/increasing-self-and-desired-psychiatric-diagnoses-among-emerging-/
More about KL Krems research: https://www.kl.ac.at/de/forschungsblog
