Possible Explainations Why?

Possible Explanations for increase

While researching the definitions of ADHD, and the history it is imperative to also look into the possible cultural reasons why there over the past decade the diagnosis of ADHD has increased.

Looking into the language used for ADHD diagnosis.

            When dealing with something that can be seen as culturally constructed and culturally variable, rather than a widely accepted medical diagnosis the language used must be considered. Many times within the United States especially the need and commonality for labels is extremely evident especially in the classroom setting.

            Jacobson (2002) compared children in the United States to children in England. Previous research had shown that about 1% of the students from England had been diagnosed with ADHD while 5-7% of students from the United States had the same diagnosis (Jacobson, 2002). Jacobson looks into detail as to why there is this difference and the language that is used between the two cultures that could play a role into these results. It is explained that many times

            The article even takes note to mention, “I would argue that given current practice any child could be labeled as ADHD if observed at the time that child is exhibiting maximum ADHD-like behaviors (Jacobson 2002).” This supports the idea that many times the diagnosis, or suggestion of diagnosis of ADHD is extremely subjective. It is possible that due to other factors such as teacher’s temperament, class size and public school versus private school can also play a role. What might be seen as disruptive, or “hyperactive” to one teacher might not be the same to another teacher.

            The article discusses the problems that might come with using language such as disruptive or hyperactive because it is so subjective. Jacobson even states, “cultures create disordering categories (2002).” When comparing the United States as a whole to other countries like England it can be seen that many times parents and teachers alike are more willing to label a disruptive or “hyperactive” child as one with ADHD than take the time to work with this child to build proper skills for inside the classroom.  Conrad and Potter (2000) attribute much of this need for labeling with the inability to deal with problems or issues in a person’s life. They discuss the idea that if things are confusing, stressful or difficult to understand patients find solace in labeling themselves as “abnormal” or “disordered” rather than having to actually deal with the problems in hand. This is not to say that there are not patients actually suffering with the side effects of ADHD, but rather to attempt to explain why more recently than not there has been an increase with these diagnoses of disorders. Society in the United States today expects much more than it did years ago, and if someone does not match up to the proper actions, and behaviors of society it is easier to make excuses than to change a course of action. Today many parents do not have the time or energy to spend expecting more of their children due to external factors like the economy and job shortages (Conrad & Potter, 2000). Loe and Cuttino (2008) explain that “almost 10 percent of ten-year-old boys in the United States take stimulants for ADHD, while only about 5 percent of ten-year-old girls do” This difference in gender medicalization can not only been seen as alarming, but also as a tribute to the culture in the United States today. Typically and stereotypically young boys are seen as rowdy, but when a culture demands for children of such young ages to act older than they actually are it sets many up for failure. The article suggest that what is known as and called ADHD has many different definitions and labels depending on the professional.

Jacobson’s research about the harm in labeling is supported by the research of Rafalovich (2001). Rafalovich (2001) believes that many parents look to guide books as to how to handle a child with ADHD. Unfortunately these “guidebooks” generalize the diagnosis and solidify in the mind of both the parent and the diagnosed child that ADHD has a direct correlation with being “abnormal.”

Many times this idea of being “abnormal” can be attributed to the structure of schools in the United States when compared to other countries. Over the past decade it is hard to deny that the United States in particular has been expecting more of students. Rafalovich (2001) discusses that this push to “higher education” at a younger age and higher expectations at a younger age could be one possible reason for more students identifying with the term “abnormal” when compared to their peers. These guidebooks have parents and children “relate” by telling personal experiences about struggling with ADHD. This feeling of a connection between the author and the reader allows for the reader to see the author as an expert and accept what they are reading as truth. Unfortunately these authors are not all experts and this many times leads to the medicalization of social problems.

Conrad and Potter (2000) shed some light on the basic ideas of the medicalization of social problems by explaining that, “nonmedical problems become defined as medical problems, usually as illnesses or disorders.” The research supports the idea that many times those diagnosed with ADHD might not have medical problems because sometimes those behind the diagnoses intentions might not be up to par. The article discusses the idea of particular interest groups pushing certain diagnosis for personal gains, rather than for the benefit of the patients. The article states, “new diagnoses rarely emerge simply as a result of new scientific discoveries (Conrad & Potter, 2000).” The article does not only pinpoint this increase of diagnoses on special interest groups but also explains that this could be due to the patients themselves. 

Conrad and Potter (2000) explain that the patient can make contributions to his or her own medicalization process. This means that it is possible for a patient to be able to self-diagnose without a professional and then go to a professional knowing the “proper” symptoms and “problems” that come with a diagnosis and describe them. Many times this may not even be intentional; however, subconsciously previous exposure to self-treatment and self-diagnosis can lead to this. ADHD along with several other medical categories that did not exist previously have been arising much more rapidly than in the past. One possible explanation of this phenomenon is that “patients have become more demanding in what they want from physicians (Conrad & Potter, 2000).”