complexity and more subtle representations of ADHD in the French media. They have observed that ‘weak biological arguments’ are now being overtaken by more ‘nuanced’ accounts that defend ‘a more com- plex understanding of ADHD etiology and treatment.’
There is clearly a huge variation in how the media have drawn on sci- entific ideas and what the public make of media discourse on ADHD.
As Seale (2003: 514) argues ‘we ought to be interested in which stories get told and which are suppressed, and in how members of the media audience (which includes health policy makers and health care provid- ers) respond to mediated health messages’. Since audio, visual and print news media are now usually linked to websites and social media that allow the public to engage with and comment on what has been said or printed, such outlets are an increasingly integral part of how the mass media works with the public. As Seale points out, media consumers are not passive recipients, there are circular feedback loops between media producers, other media producers and in turn the response of con- sumers so the direction of influence is complex (Seale 2003). Despite the media having played quite a significant role in resisting the medi- calisation of ADHD across the globe, according to studies in the UK (Horton-Salway 2011), the US (Leo and Lacasse 2015) in Australia (Robertson et al. 2013) and in Taiwan (Wang et al. 2016), Conrad and Bergey (2014) have pointed out that The Internet has been an important vehicle in the globilisation of ADHD.
internet is a burgeoning area of research in relation to ADHD (for example, Conrad and Bergey 2014; Felt 2015; Fleischmann and Miller 2013; Foroushani 2008; Kata 2010; Winter et al. 2015). In their paper on the globalisation of ADHD, Conrad and Bergey (2014) identified the Internet as one of the greatest influences affecting how information about ADHD has spread across the globe. Bussing et al.
(2012) listed the main sources of information about ADHD for the public as internet, health professionals, newspapers, and televi- sion but they identified the internet as the preferred source. Ponnou and Gonon (2017: 8) suggest that television programmes might be the trigger for internet searches and consultations with health professionals.
The internet hosts a plethora of information websites, chat rooms, forums and support groups on ADHD that are open to global pub- lic consumption (and production) although, usually, more people in information rich and developed countries have greater access to these sources of information (Conrad and Bergey 2014). It might also be the case that members of the public are inclined to take up informa- tion from websites that are in agreement with their own views and experience (Valentine 2001). Parent support groups such as UK based
‘ADDers ’ and ‘ADDiS ’ provide easy access to information, support and practical help for the public and many such websites also provide self- diagnostic checklists along with advice about seeking medical or educa- tional help.
Globally, such websites are numerous and they host forums where people can share and discuss their personal experiences. We suppose that the online discourse of parents of children with ADHD is com- plex and variable, but that they are usually sharing experience with other parents or appealing for information and support. It is there- fore important to interpret their accounts in that context. As Olstead (2002: 623) has pointed out, ‘media influence is always part of a matrix of other social influences’ so that ‘meanings are not simply received by a readership, they are mediated in relation to meanings generated and sustained by families and peer groups, and through personal experi- ence.’. Personal experience is used to interpret the ideas that circulate in the popular media and online, as Davies also demonstrates in her
analyses of parents’ accounts in Chapters 4 and 5. Descriptions of challenging children abound in personal experience stories telling of extreme behaviours and desperate parents who are struggling to cope.
Medical websites such as Netdoctor.co.uk provide support, information and checklists for the diagnosis of ADHD as do some pharmaceutical companies. Foroushani (2008) claims that these kinds of organisations and institutions have the most dominant presence on the internet and are therefore more likely to promote a medical model of ADHD even if individual medical professionals might personally be critical of this.
For example, referring to the French media, Ponnou and Gonon (2017:
9) have found that medical doctors have defended a complex ‘nuanced view of the biomedical model in newspapers, but a strictly biological one on TV’.
Conrad and Bergey (2014) point out that checklist tools ena- bling ‘do it yourself diagnosis’ have functioned to popularise the criteria for ADHD that are set out in DSM-1V and more recently DSM-5 (summarised in Chapter 2 of this volume). The UK national guidelines on ADHD (NICE 2009) are also a source of information to the public as well as health professionals on diagnosis and best practice. Matching symptoms to diagnostic checklists is therefore easier if people have access to the internet. Hence, perhaps, Stuart Justman’s (2015) observation, that the ADHD diagnosis has become a stereotype.
‘Counter-Stories’
Stereotypes are a common feature of ADHD representations but resist- ance to negative stereotypes is also a feature of some media stories that is more commonly identified in parents talk about their children (see Chapters 4 and 5 of this volume) and in adults’ accounts of their own personal experience of ADHD (Chapter 6 of this volume). Rodriguez describes how ‘counter-stories’ are used as ‘creative acts of resistance to construct positive identities.’ (Rodriguez 2010: 1183). Online dis- course is one significant forum where the public contribute to the ADHD debate and they are able to respond with ‘counter-stories’ so
they become producers as well as consumers of media discourse. This is a topic worthy of a whole volume applying to a wide range of topics.
We cannot do it proper justice here, but note that resistance to negative stereotyping and stigma is one of the many socio-political activities that people pursue online in relation to disabilities and mental health cate- gories such as autism and ADHD.
The internet hosts research studies that analyse personal experience accounts. Two examples of this are Fleischmann and Miller’s (2013) study of the online narratives of adults diagnosed with ADHD and Winter et al.’s (2015) study of women talking about ADHD on You- Tube. The narratives in Fleischmann and Miller’s study were organised around a description of ‘before and after’ stories in which experience of life before diagnosis is compared with transformations after. Narratives that pivot around diagnosis are also common in other health condi- tions (see, for example, Horton-Salway 1998, 2001; Wynne et al. 1992).
Many such stories refer to the effect of diagnosis on lives (further dis- cussion of voices of experience in Chapter 6). In the case of ADHD diagnosed in adult life, this can refer to confusion and difficulties expe- rienced prior to diagnosis and the relief that follows medical and social recognition. For example, Fleischmann and Miller (2013: 47) describe the accounts of women who reported ‘repeated failures in many aspects of life’ and contrasted this with ‘a more coherent view of their life and their difficulties’ after the diagnosis. These stories feature accounts of adults with ADHD who ‘could overcome their challenges.’ and who could ‘take a more positive view of themselves…and admit to some positive aspects of having ADHD’ (2013: 47). Fleischmann and Miller described the way that the conclusions of such narratives told of ‘con- fidence and future expectations’ (2013: 55) and improved self- image following diagnosis. These stories are therefore as much about social identities as they are about the events and difficulties of people’s lives.
Winter et al. (2015: 415) analysed women’s accounts on You-Tube, argu- ing that a diagnosis of ADHD is sometimes used by women, burdened by pressures to perform as ‘superwomen’, to excuse their failings and jus- tify performance enhancing medication. This was not directed as a criti- cism of the women, but an argument arising from a feminist perspective, that women are ‘active consumers’ of the ADHD diagnosis’ to avoid the
stigma of failing to live up to societal expectations about the demands and burdens placed upon them to perform multiple roles. However, we note that the women in this study had also emphasised the positive aspects of having ADHD, such as ‘the ability do five things at once’ or their ‘creativity’. These were also stories of ‘unique’ and ‘successful lives’
despite a plethora of problems (Winter et al. 2015). Such accounts con- struct more positive social identities and echo the transformational sto- ries that appear in newspaper reports in the form of resistance to the more common and stigmatising negative identities that are represented.
O’Dell et al. (2016) have identified similar themes in accounts of wom- en’s personal experience that will be discussed further in Chapter 6.