Credit: Public Relations for Research & Education

More and more young adults seek psychological assessment with a diagnosis already in mind—or even one they have assigned to themselves. A new mixed-methods study with 93 clinical psychologists shows that self-diagnosed and "desired" psychiatric labels—often ADHD or autism—are now far more common than just a few years ago. According to the clinicians, this is seen particularly among young women with higher education and intensive social media use, some of whom react to unexpected results by "diagnosis shopping."

Conducted under the lead of Karl Landsteiner University (KL Krems), the study shows how these dynamics are changing routine diagnostic encounters and why communication in mental health care needs to adapt. The research is published in the International Journal of Clinical and Health Psychology.

Today, social media and streaming platforms are key sources of (mis)information about mental health, with many young people first encountering diagnostic terms on TikTok, Instagram or TV series. For some, identifying with a diagnosis online is a first step towards seeking help; for others, labels become part of how they define themselves and present their lives to peers. Until now, little was known about how clinicians view these trends or how they affect day-to-day assessment work. To address this, the Research Center Transitional Psychiatry at KL Krems surveyed licensed clinical psychologists across Austria about their experiences with self- and desired diagnoses among emerging adults.

Diagnosis = identity

"Many young adults no longer come to an assessment with an open question like ‘What is going on with me?,’" says Dr. Gloria Mittmann MSc, Scientific Staff at the Research Center Transitional Psychiatry. "They arrive with a very specific label they have already chosen for themselves—often ADHD or autism—and a strong wish to have this identity confirmed."

According to Mittmann, this can have understandable motives: a formal diagnosis can make everyday struggles feel less like personal failure and more like something that has a name and an explanation. At the same time, it raises the stakes for the assessment process. "If a diagnosis has become central to how a person sees themselves, any discrepancy between their expectation and a clinical judgment can feel deeply threatening," she explains.

The survey results show how widespread these dynamics have become. Most participating clinical psychologists reported that both self-diagnoses and desired diagnoses now occur "more often" or "much more often" than in previous years. Only a small minority perceived no change, and virtually none reported a decline. ADHD and autism spectrum disorder clearly dominated both categories, while other conditions were mentioned far less frequently.

Typical patients presenting with such expectations were described as predominantly female, with higher education and intensive online media use. When asked about motives, psychologists most often pointed to relief from guilt or responsibility, the wish to make sense of long-standing difficulties, and the appeal of belonging to a recognized identity group. By contrast, gaining access to medication or psychotherapy was named less frequently as a primary driver.

New challenges

The qualitative analysis shows how these expectations shape the assessment situation. Many clinical psychologists described extensive "half-knowledge" brought in from social media, online self-tests or peer discussions. This often included a narrowed or distorted view of diagnostic criteria and a tendency to over-pathologize everyday experiences. In questionnaires and interviews, some patients appeared to answer in a diagnosis-driven way—emphasizing symptoms that fit the desired label, even when developmental histories or third-party reports did not support this picture. Psychologists also reported reduced openness to alternative explanations.

When the final assessment did not confirm the expected label, strong reactions were the rule rather than the exception. These ranged from disappointment and sadness to anger, harsh criticism of clinicians, or "diagnosis shopping"—seeking out further assessments until the wished-for diagnosis was obtained. In some cases, psychologists described explicit pressure to change reports or threats of complaints and negative online reviews. This makes feedback sessions crucial: they need to combine clear professional reasoning with a great deal of empathy.

"Clinical psychologists need to explain very transparently how they arrive at their conclusions, while at the same time recognizing that for some patients the desired diagnosis has become part of their identity story," says Mittmann.

Overall, the findings suggest a broader shift in how young people relate to mental health diagnoses. For many, labels such as ADHD or autism no longer function only as clinical categories, but also as social identities that offer belonging and recognition. Clinical psychology should respond by addressing self-diagnosis and desired diagnoses in training, by strengthening skills for giving feedback in high-stakes situations, and by engaging more actively with online mental health cultures.

This work in collaboration with the Medical University of Vienna and the University Hospital Tulln, a teaching and research center of KL Krems, aligns with KL Krems’ research focus on interdisciplinary fields with high relevance to health policy, including mental health and neuroscience. By documenting clinicians’ experiences, the study provides a basis for more realistic planning of diagnostic services and for discussion on how to protect diagnostic integrity and patient well-being.

More information

Matthias Neumann et al, Increasing self- and desired psychiatric diagnoses among emerging adults: Mixed-methods insights from clinical psychologists, International Journal of Clinical and Health Psychology (2026). DOI: 10.1016/j.ijchp.2025.100661

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