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On May 8, 2021, Elon Musk, a well-recognized entrepreneur and business magnate, revealed on a popular television show that he has Asperger syndrome. Research has shown that people’s perceptions of a condition are modified when influential individuals in society publicly disclose their diagnoses. It was anticipated that Musk's disclosure would contribute to discussions on the internet about the syndrome, and also to a potential change in the perception of this condition.
The objective of this study was to compare the types of information contained in popular tweets about Asperger syndrome as well as their engagement and sentiment before and after Musk’s disclosure.
We extracted tweets that were published 1 week before and after Musk's disclosure that had received >30 likes and included the terms “Aspergers” or “Aspie.” The content of each post was classified by 2 independent coders as to whether the information provided was valid, contained misinformation, or was neutral. Furthermore, we analyzed the engagement on these posts and the expressed sentiment by using the AFINN sentiment analysis tool.
We extracted a total of 227 popular tweets (34 posted the week before Musk’s announcement and 193 posted the week after). We classified 210 (92.5%) of the tweets as neutral, 13 (5.7%) tweets as informative, and 4 (1.8%) as containing misinformation. Both informative and misinformative tweets were posted after Musk’s disclosure. Popular tweets posted before Musk’s disclosure were significantly more engaging (received more comments, retweets, and likes) than the tweets posted the week after. We did not find a significant difference in the sentiment expressed in the tweets posted before and after the announcement.
The use of social media platforms by health authorities, autism associations, and other stakeholders has the potential to increase the awareness and acceptance of knowledge about autism and Asperger syndrome. When prominent figures disclose their diagnoses, the number of posts about their particular condition tends to increase and thus promote a potential opportunity for greater outreach to the general public about that condition.
Asperger syndrome (hereafter referred to as Asperger), which was removed from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a formal diagnosis, is currently merged with autism and pervasive developmental disorders that are otherwise not specified within “autism spectrum disorder” (hereafter referred to as autism). Although the International Classification of Diseases framework in its current 10th edition has not yet formally removed Asperger as a diagnosis; it will do so within the 11th version that is forthcoming [
Previous research has shown that the combination of key figures in society and their disclosures of personal diagnoses can affect the public’s perception of their conditions [
The objective of this study was to compare the types of content used in (informative, misinformative, or neutral), the engagement with, and the sentiment of popular tweets about Asperger before and after Musk’s disclosure.
We designed a cross-sectional study to analyze the type of content, engagement, and perception of popular tweets related to Asperger. We defined popular tweets as those with more than 30 likes as this is slightly higher than the average of 25 likes reported in previous research [
We used the Twitter advanced search engine to find popular tweets (>30 likes) that were posted in English and included the terms “Aspergers” or “Aspie.” The term “Aspie” was included because it is a common slang term used by the autism community to refer to Asperger [
From the selected popular tweets, we extracted the post message and the number of comments, retweets, and likes. We extracted only the original tweets and no personal or identifiable data were collected.
We created a coding guideline, which was used to classify the tweets (the coding guideline is available in the data repository) [
We analyzed the perceptions or sentiments of each post using the AFINN sentiment analysis tool [
All statistical analyses were performed using SPSS (version 25.0; IBM Corp). Both the data set and data analysis, including scripts, were made available in the data repository [
We extracted a total of 227 popular tweets. A total of 34 (14.9%) tweets were posted the week before the Musk announcement and 193 (85%) were posted the following week.
When we compared the engagement and sentiment of tweets before and after Musk's announcement, we found that tweets posted before the disclosure received significantly more engagement; they received more comments (254.15, 95% CI 87.1 to 331.5 compared to 44.88, 95% CI –74.6 to 493.2;
Engagement with and sentiment of popular tweets about Asperger according to the time points when they were posted and the type of information provided.
Category of engagement | Time point when the tweet was posted | Type of information provided | ||||||
|
Before Musk’s disclosure (n=34), mean (95% CI) | After Musk’s disclosure (n=193), mean (95% CI) |
|
|
Provides information (n=13)c, mean (95% CI) | Neutral tweets (n=210)d, mean (95% CI) | Contains misinformation (n=4), mean (95% CI) |
|
Comments | 254.15 (87.08 to 331.46) | 44.88 (–74.63 to 493.16) | 3.375 | <.001 | 68.77 (–43.36 to 180.93) | 77.96 (30.12 to 125.79) | 9.50 (–0.77 to 19.77) | .81 |
Retweets | 494.47 (–28.30 to 635.65) | 190.80 (–321.57 to 928.91) | 1.803 | .001 | 146.66 (–47.94 to 340.86) | 246.00 (117.76 to 374.23) | 18.25 (–7.29 to 43.79) | .59 |
Likes | 7058.00 (1734.96 to 10,443.57) | 969.44 (–4483.23 to 16,661.76) | 2.756 | .001 | 824.00 (–216.54 to 1864.54) | 1980.41 (277.11 to 3683.72) | 124.75 (–26.96 to 276.46) | .26 |
Sentiment | 0.12 (–1.42 to 1.08) | 0.29 (–1.29 to 0.95) | 0.272 | .22 | –1.46 (–3.20 to 0.28) | 0.38 (–0.09 to 0.84) | 0.00 (–2.60 to 2.60) | .21 |
a
b
cExample of a tweet that provides information: “Not all autistic people (including people with Asperger’s diagnoses) are white, male techie types. Some of us are poets. Some of us are even women.”
dExample of a neutral tweet: “Elon Musk reveals he has Asperger’s syndrome during SNL monologue.”
The interrater agreement for the classification of the tweets and respective tweet data provided was κ=0.469 (moderate agreement). We classified 210 (92.5%) of the 227 tweets as being neutral, 13 (5.7%) tweets as informative, and 4 (1.8%) as containing misinformation. Both informative and misinformative tweets were posted after Musk’s disclosure. Tweets identified as misinformative included the following examples: tweets suggesting that Musk’s Asperger was deeply problematic, a tweet suggesting that autism and Asperger are the results of asymmetrical brain stem injuries, and a joke related to Musk’s development of the SpaceX Starship and the need of people with autism to travel into space.
We found that after Musk's disclosure, the number of popular tweets about Asperger increased by almost 6-fold. This increase in tweeting has the potential to promote awareness of the Asperger condition to more social media users. However, these “after” tweets seemed to receive less engagement than the ones posted before the disclosure.
As this was an observational study, the association between Musk´s disclosure and the increase in the number of tweets about Asperger receiving less engagement warrants further research to assess other possible factors affecting these results. It is nevertheless noteworthy that after Musk’s disclosure, discussions about Asperger on Twitter increased. On May 9, 2021, Asperger became the 19th top trending topic on Twitter [
With the increase of popular posts about Asperger, both informative and misinformative tweets also appeared. Although nonsignificant, the few popular tweets that did contain misinformation tended to receive less engagement than posts that provided neutral or informative content. The lower engagement with tweets containing misinformation could suggest a kind of collective intelligence among Twitter users [
Considering the impact that celebrity culture has on directing the public’s attention to matters of health, it is worthwhile to investigate the types of information displayed on social media [
Promoting the awareness and acceptance of Asperger and autism by posting informative and factual content on social media platforms such as Twitter could assist in increasing social media users’ knowledge about and understanding of the condition. Research on the use of social media for health promotion has shown its positive effects related to different conditions [
Our study had several limitations. We focused on a short period of time. We collected popular tweets about Asperger that were posted only in English. Furthermore, we only analyzed tweets posted the week after Musk’s announcement, which may not be enough to form a conclusion on the effect of the disclosure. Also, Twitter users may not be representative of a random sample of the population, as the platform’s users tend to range in age from 25 to 34 years [
The use of social media platforms by health authorities, autism associations, and other stakeholders has the potential to increase awareness of and knowledge about both Asperger and autism. When prominent figures disclose their conditions, such as autism, posts about their condition tend to increase, which provides an opportunity for trustworthy information about the condition to reach more social media users. Future research on autism and celebrity engagement with media should deploy in-depth data collection and longitudinal designs to detect possible changes in sentiment, as well as different methodological approaches (eg, qualitative, quantitative, and mixed designs) to elucidate underlying mechanisms at play related to the spread of both information and misinformation.
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
We would like to thank Leanne Noelle Strom for her help with proofreading.
None declared.