This volume is the third book in the book series The Language of Mental Health (ed. How the discourse on mental health is constructed through negative stereotypes about disability that are both adopted and contested in the discourse.
Introduction
Attention deficit hyperactivity disorder (ADHD) has been one of the most debated medical categories affecting children in different parts of the world. Despite the classification of ADHD as a category of mental health, there has been no absolute consensus historically and even currently about its status as a medical condition, its meaning and causes, which continue to be debated, researched and debated by scientists and medical professionals. educators, multimedia and members of the public.
Science, Fact Construction and ‘Ships in Bottles’
The origins of medical interest in the social and psychological world have evolved in part with the development of the social, psychological, and health sciences that now inform the application of the biopsychosocial model to medicine. Not integration at all, he asserts, but "a colonization of psychology and the social by the biological" in a way that reduces social and environmental influences to mere triggers of "a secret genetic bomb."
Our Approach
We focus on how the facts of ADHD are constructed in theory, the media and lay discourse, and how a mental health category like ADHD can rely for its meaning on different forms of cultural representation, such as the construction of social identities and forms of gendering that can be both obvious and subtle. ADHD is recognized as a mental health category by the Diagnostic and Statistical Manual of Mental Disorders (APA 2013).
The Structure of the Book
Alison Davies first examines the perspective of mothers and examines how they are positioned by dominant discourses about ADHD and parenting. An analysis of the discourse on ADHD is not complete without acknowledging the personal perspectives of health professionals and educators.
There are some insightful research studies that have explored these contexts in detail elsewhere, but we suggest that further qualitative research into clinical contexts and the perspectives of health professionals and educators would be useful to sustain a productive dialogue about ADHD and other forms of mental health care hold. Framing children with ADHD: A critical examination of the history, discourse, and everyday experience of attention deficit.
Mapping the Discourses of ADHD
This chapter examines how ADHD has been constructed in historical discourse and how this has influenced contemporary understanding, specifically how it has come to be scientifically theorized as biological. We favor a Foucauldian view of discourse as a construct of meaning (Foucault and how discourse and regimes of truth define what is knowable, how we should behave and the types of identities we can assume.
The Historical Legacy
Of course, new values about what is normal, correct or acceptable change according to social and historical context. Conceptions of what constitutes mental distress have changed according to the historical discourses of the time and these inevitably shape the way individuals understand themselves and others.
Biological Explanations
As with Still's “moral imbecile,” the identification of these “disorders” in children took place in schools where the behavior was considered inappropriate and problematic. Hawthorne also emphasizes “the dichotomy between facts and values” in the way socially valued concepts become infused into the language of science (Hawthorne 2010: 25).
Psychological Explanations
The identification of "disorder" in children is closely related to the development of the "discipline of the psyche" and the emerging science of developmental psychology. Within this discourse, ADHD is positioned as a developmental problem to be addressed within the context of the family.
Sociological Explanations
The legitimacy of the scientific/medical label for ADHD is one that has been taken up globally and is now the most commonly diagnosed childhood psychiatric condition in the world (Bailey 2014). For example, in the UK, the sharpest increase in the number of methylphenidate prescriptions (an increase of over 2000% between 1991 and 1996) coincided with Cuba-Geigy, the largest supplier of methylphenidate, in the UK. (Norris and Lloyd 2000).
The Biopsychosocial Approach
A biopsychosocial approach assumes that the child's social context may influence the development of ADHD, thereby involving families in the production and treatment of ADHD. This could explain why, despite calls for a biopsychosocial approach, medication remains an important method in the treatment of ADHD.
Concluding Comments
Available at www.nhs.uk/Conditions/Attention-deficit-hyperactivity- disorder/Pages/Introduction.aspx (Accessed 14 September 2017). Attention-deficit hyperactivity disorder: Diagnosis and management of ADHD in children, youth, and adults.
Media Representations of ADHD
The understanding of ADHD has been constructed over historical time, polarizing competing explanations about biological/genetic causes versus psychosocial influences. The biopsychosocial explanation of ADHD, arising from the interplay of biological psychological and social factors, is itself a theoretical model that has shaped the understanding of ADHD according to the greatest complexity, at least in theory.
ADHD, Media Concerns and Media Framing
The construction of ADHD in the media and its focus on extreme behavior problems, social categories of 'bad boys'. This is the challenge the media faces in presenting ADHD as a controversial category and for the public trying to understand it.
Newsworthiness and the Decline of Scientific Authority
He wrote about the coverage of ADHD in the French media, and Gonon et al. 2011) argued that there is often a discrepancy between 'neurobiological facts and the fixed conclusions advanced by the media' (2011: 1). For example, Lloyd and Norris (1999) and Norris and Lloyd (2000) pointed out a polarization around the 'parental voice' in their discussion of the role of media discourse and the rise of ADHD in the UK.
ADHD Discourse and ‘The Internet’
Although the media has played a fairly important role in resisting the medicalization of ADHD around the world, studies in Britain (Horton-Salway 2011), the US (Leo and Lacasse 2015) and Australia (Robertson et al. 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 globalization of ADHD. Medical websites such as Netdoctor.co.uk provide support, information and checklists for diagnosing ADHD, as do some pharmaceutical companies.
Metanarratives and Gendering Identities
Misrepresentation of neuroscientific data can lead to misleading conclusions in the media: the case of attention deficit hyperactivity disorder. The importance of the lay press in communicating medical knowledge to the scientific community.
Normal Rules of Parenting Don’t Apply’: ADHD, Maternal Accountability
101 It is also very confrontational at times and normal rules of parenting do not apply because they will always go to the next level. The next two chapters examine how social and gendered identities are constructed in parents' accounts of their own experiences.
How parents' social and gender identities are captured in biological, psychological and social explanations of ADHD and wider discourses about parenting in general. We will discuss how broader gendered discourses of parenting intersect with those of ADHD to create a cultural context for the construction of parenting experiences.
Contemporary Parenting Discourses
For example, recent studies have included a focus on the effects of parental involvement on the learning of children with ADHD (Rogers et al. 2009) and the 'qualities' (such as warmth and responsiveness) of parents of boys with hyperactivity (Keown 2011). Group-based parenting programs are commonly recommended for parents of preschool children with ADHD (Smith et al. 2014).
Gendered Care-Giving and the Blameworthy Mother
For example, Gray Brunton et al. 2014) found that parents of children with ADHD invoked attachment, marital separation and discipline as possible explanations for their child's problems. Parents of children with ADHD can be understood to experience public stigma (Mueller et al. 2012) due to the deficit parenting stereotypes that circulate in society and within the media.
Resisting Discourses of Blame: Turning to the Biomedical Model
The 'spread of the discourse of normative child development' (O'Dell and Brownlow) is evident in the way mothers indirectly orient their children's deviation from the 'normative'. The availability of knowledge about ADHD, particularly from medical websites that list diagnostic criteria (Conrad and Bergey 2014; . Foroushani 2008), makes everyone a potential expert which means 'the professional hero is no longer a safe category' (Seale 2003: 523).
The Intensification of Maternal Responsibility
Nevertheless, the discourse of 'choice' and user involvement in decision-making is part of contemporary healthcare practice, and this is implied by Rachel's account. Taking responsibility for children's medications is just one example of the extensive care practices required of mothers once their children are diagnosed with ADHD.
Parenting-as-a-Project
Paula's developing skills and knowledge in relation to her son is an example of a project of 'coordinated cultivation' (Lareau 2003; Blum 2007) where 'good' parents become concerned with their children's development. They 'act as vigilantes who seize authority from legitimate, approved professionals on behalf of their children' (Blum 2007: 222).
Resisting Troubled Identities
Mothers of children with ADHD view themselves as objects of scrutiny and subjects of blame (Blum 2007; Singh 2004; Malacrida 2001). In turn, fathers are identified as 'hard to reach', the 'invisible parent' and the 'peripheral parent' (Carpenter and Towers) such that the stereotype of the absent father has become a common theme in ADHD discourse.
Just an Active Boy’: Intersecting Discourses of ADHD, Masculinity
Within research, policy and clinical practice in issues relating to family and children, there is a focus on mothers (see Panter-Brick et al. 2014). The focus on mothers in research studies about children with ADHD is likely related to the absence of fathers from the ADHD diagnostic process (see Berman and Wilson 2009; Hjorne 2005; Singh 2003).
Due to the negative stereotypes circulating in public debate, the identity of the 'good father' is at stake in the stories about fathers and sons. However, there is more than one way to represent the idea of a “good father” and these variations intersect with discourses of ADHD, ideas of masculinity, and father identities.
Contemporary Debates Around Fathering
This highlights the varying ways of defining 'good fatherhood' that can lead to tensions and opportunities for fathers, at work and in family life (Ranson 2001). When discussing these topics, discourses of “good fatherhood” can appear contradictory and lead to ideological dilemmas (see Billig et al. 1988; Edley and Wetherell 1999).
Traditional Fathers and Lenient Mothers
John: I'm very stubborn and stubborn, but even for me, yeah, it brought me down […] and I know for sure it brought Ingrid down because, like I said, she was in tears. Ingrid: there were times when I just cracked and I just couldn't uhm John: I couldn't deal with it […] and I can… see people out there.
The Problem with Boys
Alan and Jane continued in this interview to represent ADHD as an inherited family trait by comparing their son's behavior to Alan's father: As with fathers of children with autism, Mick gives a positive assessment of his son's characteristics (see Potter 2016b).
Talking About Medication
It is Jane (the child's mother) who gives a positive evaluation of the effect medication had on her husband, 'it helped you rationalize'. Gill's defense of medication is emphatic and certain, and her language is not provisional: 'it means it will have 100% impact on his ability to learn'.
The Good Parenting Team
The secondary role of fathers described in such examples is often justified by the demands of their working lives and their partners. The association between ADHD and particular forms of masculinity and social behavior is a defining feature of the discourse on ADHD, and this raises a question regarding girls and women with ADHD.
The Emergence of ADHD as a Life-Long Condition
For a long time, the category of ADHD was considered exclusively a childhood disorder until it was defined as a diagnosable mental health category that continues into adulthood and affects girls and women as well as men and boys. In this chapter, our journey through the discourse on ADHD continues with a discussion of some of the issues and debates that have arisen from the emergence of ADHD in adults, the implications of gender and the importance of personal narratives of experience.
Voices of Experience: Narrative Lives and Selves
In the next version, DSM-IV (American Psychiatric Association 1994) confirmed ADHD as an adult diagnosis and it was recommended that it should be based on the 'Conners ADHD Adult Diagnostic Interview for DSM-1V' (American Psychiatric Association 1994). Another layer of complexity in the discourse of adult ADHD is gender bias towards boys in recognition and diagnosis.
The Consequences of Gendering
This deserves attention because of the gender stereotypes that support the definitions of ADHD and the different consequences this has for girls, women, boys and men. We continue here with a brief account of how different perspectives have looked at the gendering of ADHD and how this has entered the discourse surrounding ADHD in adults.
