Introduction: Extreme online challenges consist in taking part in challenges proposed on web and sharing the results in videos posted on social media. The use of social networks is widespread among the very young, giving easy access to potentially dangerous content with consequences on health.
Evidence acquisition: The aim of this literature review was to describe the most common challenges involving children and adolescents over the last 20 years. We focused on participants features (such as age, sex and psychological background) and health implications. The review included research articles and reviews published between 2000 and 2021. We used Pubmed, Scopus and Web of science as search engines.
Evidence synthesis: Many types of online challenges emerged from the analysis of the literature. The most common challenges are those that lead to self-harm, which involve acts at risk of choking and challenges that potentially lead to suicide and ingestion of substances. The extreme challenge phenomenon is a public health issue that affects a vulnerable population, as it is young and susceptible to peer pressure influence. Participants often showed problematic personality traits, making them more likely to get involved in these behaviors.
Conclusions: It is necessary for parents, teachers and health workers to be aware of the spread of the online challenges, to improve prevention interventions in the age groups involved.