Concerning Social Media Challenges

Question: What do we know about the role of social media challenges and injuries in children? Do we have any evidence-based ways to address these potentially life-threatening social media challenges?

Answer: Social media challenges can be very creative – from the “mannequin” challenge, where participants stay as still as possible during the video clip, to the Try Not to Laugh challenge, where players try their best not to laugh while watching funny videos. Some are used to support community efforts. The most notable example is the Ice Bucket Challenge, where participants pour ice water on themselves to raise money for ALS (amyotrophic lateral sclerosis) research. This was an incredibly successful social media trend, with more than 17 million participants successfully raising $115 million in donations towards ALS research. 

While many of the trending challenges on social media simply provide awareness or comic relief, others can lead to harmful outcomes. 

• An example of a social media challenge is the ingestion challenge, where individuals are prompted to consume non-food items like Tide Pods or to ingest excessive amounts of substances typically consumed sparingly, such as cinnamon. Peak Google search times of four popular social media ingestion challenges (Benadryl, Tide Pods, cinnamon, and nutmeg) correlated with an increased number of ingestions of that substance reported to United States poison centers.  
• Research on a popular challenge in East Asia called the A4 challenge, where participants would pass if their waist was smaller than the width of a piece of A4 paper, found that while increased viewing of the challenge was not associated with disordered eating behaviors, study participants with pre-existing body dissatisfaction had a greater risk of exacerbating these feelings about themselves.  
• A very extreme case is the choking challenge, where participants seek out a “high” or euphoric feeling from hypoxia, which occasionally resulted in seizures or death. Researchers found that around 25% of the posted content on this trend sought to prevent viewers from trying the challenge themselves and had higher amounts of views than nonprevention videos but disappointingly more “thumbs down” ratings.  

How do we address the potential negative effects of social media challenges? 

Existing research offers suggestions for a wide array of audiences including social media platforms, policy makers, nonprofits, educators, clinicians, and families to combat the negative effects of social media challenges.  

• Share safe messaging guidelines more widely. This could include educating social media users on responding to and reporting unsafe posts.  
• Remove dangerous videos promoting concerning social media trends.   
• Create more accurate and higher quality prevention videos.  
• Encourage body acceptance. Drawn from the A4 challenge, one research team advocates for promoting various ideas of what’s attractive in media and ads.   
• Talk with families to raise awareness and build open communication channels. Clinicians can ask adolescents whether they've seen anything on social media that's worried them lately and open a discussion during a well child visit. Parents can encourage their adolescents to talk with them about what they see on social media and maintain an open line of communication.  
  • Read and share these articles from Common Sense Media: 
    • Help kids navigate social media stunts offers tips for parents on how they can approach their children about social media challenges. 
    • 13 online challenges your kid already know about provides a brief description of 10 different popular social media challenges, both serious/dangerous ones and funny ones. 
• Provide media literacy education. A comprehensive media literacy education for adolescents could play a crucial role in helping teens make thoughtful judgements about their social media engagement.  
  • These Media literacy resources for classrooms from Common Sense Media include tips for adults on how to educate their classroom or child about safe media navigation skills.  

References 

• Abraham, J., Roth, R., Zinzow, H., Madathil, K. C., & Wisniewski, P. (2022). Applying Behavioral Contagion Theory to Examining Young Adults’ Participation in Viral Social Media Challenges. ACM Transactions on Social Computing, 5(1–4), 3:1-3:34.  
• Defenderfer, E. K., Austin, J. E., & Davies, W. H. (2016). The Choking Game on YouTube. Global Pediatric Health, 3, 2333794X15622333.  
• Jackson, T., Ye, X., Hall, B. J., & Chen, H. (2021). “Have You Taken the A4 Challenge?” Correlates and Impact of a Thin Ideal Expression From Chinese Social Media. Frontiers in Psychology, 12, 669014.  
• Khasawneh, A., Chalil Madathil, K., Dixon, E., Wiśniewski, P., Zinzow, H., & Roth, R. (2020). Examining the Self-Harm and Suicide Contagion Effects of the Blue Whale Challenge on YouTube and Twitter: Qualitative Study. JMIR Mental Health, 7(6), e15973.  
• Marshall, R. D., Bailey, J., Lin, A., Sheridan, D. C., Hendrickson, R. G., Hughes, A., & Horowitz, B. Z. (2024). Impact of social media “challenges” on poison center case volume for intentional ingestions among school-aged children: An observational study. Clinical Toxicology (Philadelphia, Pa.), 62(3), 183–189.  
• The ALS Ice Bucket Challenge: 10th Anniversary | The ALS Association. (n.d.). Retrieved June 10, 2024.

Age: 13-17 

Topics: social media challenges, injury  

Role: Clinician