An increasing number of young adults now approach psychological assessments with a diagnosis already in mind—or one they have assigned to themselves. A new mixed-methods study involving 93 clinical psychologists reveals that self-diagnosed and “desired” psychiatric labels, particularly attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder, have become far more common in recent years. Conducted under the leadership of Karl Landsteiner University of Health Sciences (KL Krems), the study highlights how these expectations are reshaping routine diagnostic encounters and why mental health communication must evolve accordingly.
According to participating clinicians, this trend appears especially pronounced among young women with higher levels of education and intensive social media use. Notably, some individuals respond to unexpected assessment outcomes by seeking repeated evaluations—a phenomenon clinicians describe as “diagnosis shopping.”
Social Media as a Gateway to Mental Health Labels
Today, social media platforms and streaming services play a central role in how young people encounter mental health information—and misinformation. Many first learn about diagnostic terms such as ADHD or autism through TikTok, Instagram, or television series. For some individuals, identifying with these labels online serves as a first step toward seeking professional help. For others, however, diagnostic terms become integral to personal identity and social self-presentation.
Until now, limited evidence existed on how clinicians perceive these developments or how they influence daily diagnostic practice. To close this gap, researchers at the Research Centre Transitional Psychiatry at KL Krems surveyed licensed clinical psychologists across Austria, focusing on their experiences with self-diagnosed and desired diagnoses among emerging adults.
When Diagnosis Becomes Identity
“Many young adults no longer come to an assessment asking, ‘What is going on with me?’,” explains Dr Gloria Mittmann MSc, Scientific Staff at the Research Centre Transitional Psychiatry. “Instead, they arrive with a specific label they have already chosen—most often ADHD or autism—and a strong wish to have that identity confirmed.”
As per the press release, Dr Mittmann notes that these expectations often stem from understandable motives. A formal diagnosis can reduce feelings of guilt or personal failure by providing an explanatory framework for long-standing difficulties. However, this dynamic also intensifies the assessment process. When individuals closely tie a diagnosis to their sense of self, any divergence between expectation and clinical judgement can feel deeply destabilising.
Widespread and Growing Clinical Impact
Survey findings indicate that most participating psychologists now encounter self-diagnoses and desired diagnoses “more often” or “much more often” than in the past. Only a small minority reported no noticeable change, and almost none observed a decline. ADHD and autism spectrum disorder overwhelmingly dominated both categories, while other psychiatric conditions appeared far less frequently.
Clinicians described typical patients as predominantly female, highly educated, and heavily engaged with online media. When asked about underlying motivations, psychologists most often cited the desire to make sense of persistent difficulties, relief from perceived responsibility, and the appeal of belonging to a recognised identity group. In contrast, access to medication or psychotherapy emerged less frequently as a primary motivator.
New Challenges in Diagnostic Practice
Qualitative analyses further illustrate how these expectations affect the assessment process. Many psychologists reported that patients often bring extensive “half-knowledge” acquired from social media, online self-tests, or peer discussions. This information frequently reflects a narrowed or distorted understanding of diagnostic criteria and a tendency to pathologise everyday experiences.
Moreover, clinicians observed that some individuals respond to interviews and questionnaires in a diagnosis-driven manner, emphasising symptoms that align with their preferred label—even when developmental histories or third-party reports contradict this narrative. As a result, psychologists noted reduced openness to alternative explanations for symptoms.
Emotional Reactions and Diagnosis Shopping
When assessments fail to confirm the expected diagnosis, strong emotional reactions are common. Psychologists described responses ranging from disappointment and sadness to anger, accusations of incompetence, or persistent efforts to obtain the desired diagnosis elsewhere. In some instances, clinicians reported explicit pressure to alter reports or threats of formal complaints and negative online reviews.
Consequently, feedback sessions have become increasingly critical. Psychologists must clearly explain their clinical reasoning while simultaneously responding with empathy and sensitivity. “Clinicians need to communicate transparently how they reach their conclusions,” says Dr Mittmann, “while acknowledging that the desired diagnosis may form an important part of a patient’s identity narrative.”
Implications for Mental Health Care and Training
Overall, the findings point to a broader cultural shift in how young people relate to psychiatric diagnoses. Labels such as ADHD or autism now function not only as clinical categories but also as social identities that offer recognition and belonging.
In response, clinical psychology must adapt by addressing self-diagnosis and desired diagnoses more explicitly in professional training. Strengthening skills for delivering feedback in emotionally charged situations and engaging more actively with online mental health cultures will be essential.
Conducted in collaboration with the Medical University of Vienna and University Hospital Tulln—a teaching and research centre of KL Krems—this research aligns with KL Krems’ focus on interdisciplinary fields of high relevance to health policy, including mental health and neuroscience. By systematically documenting clinicians’ experiences, the study provides a foundation for better planning of diagnostic services and for ongoing discussion on safeguarding diagnostic integrity while prioritising patient well-being.