> Although some patients indeed suffered in addition from mild Tourette syndrome, for all newly emerged symptoms, it could be clearly ruled out that they were tics for several reasons: (i) onset was abrupt instead of slow, (ii) symptoms constantly deteriorated instead of typical waxing and waning of tics, (iii) “simple” movements (e.g. eye blinking) and noises (e.g. clearing one’s throat) were clearly in the background or completely absent, although being the most common and typical symptoms in Tourette syndrome, (iv) movements were mainly complex and stereotyped and predominantly located at arms and body, instead of at eyes and face, (v) overall, the number of different movements, noises, and words was “countless” and far beyond the typical number of tics in Tourette syndrome, and (vi) premonitory feelings were reported with atypical location, quality, and duration compared to tics in Tourette syndrome. Thus, worsening of pre-existing Tourette syndrome, for example due to COVID-19 pandemic as suggested elsewhere 4,5, can be clearly ruled out in our patients.
I've been diagnosed with Tourette's for 23 years and the above is not what I would describe as "universally mimicking a specific symptom set precisely"
That doesn't mean this kids aren't dealing with something real, but it means it's unlikely to be Tourette's. The lack of low-level background tics (blinks, throat clearing, facial grimaces) is a huge tell.
The worst case scenario here is they get misdiagnosed with Tourette's and start treatment that a) won't help them and b) will give them terrible side effects. I've been through the roulette wheel of powerful brain meds, you do not want to go down that road if you don't have to.
It doesn’t apply to long explicit patterns like a school play, but happens with pieces of behavior that are much shorter in a context-specific way: unless you observe a suitable situation, you wouldn’t know A unconsciously mimics B in behavior X. Additionally, the role of B in A’s life can make behavior mimicry strongly intrinsically motivated, which is a rare chance with a school play.
Keep in mind the scale of TikTok. What is the sample size where one might? One out of a school? There's still millions of them available.
I'm not saying this is true or not, but being worldwide accessible changes perspective a bit.
In middle school I used to look at what drugs were prescribed for what mental illness, then read the DSM–4 for the symptoms, book an appointment for a specialist so I could get those drugs.
Faking mental illness is extremely easy and extremely enjoyable.
I've been to endless elementary school plays; I've seen that kids really don't have the refined performance skill to pull this off. One might but not scores.