Researchers planning a survey of attention-deficit hyperactivity disorder in China, Indonesia, Japan, and the United States have found that applying this diagnosis across cultures may prove tricky. Mental health clinicians perceive children's hyperactive and disruptive behaviors in markedly different ways from one country to another, even when using a uniform rating system, report psychiatrist Eberhard M. Mann of the University of Hawaii in Honolulu and his colleagues.
The researchers videotaped four 8-year-old boys, two from Honolulu and two from Tokyo. At each site, one boy was recruited from children receiving treatment for problem behaviors at a mental health clinic and another was chosen at random from an elementary school. Videotapes first showed each boy drawing a picture by himself and then building a block tower with several other boys.
Groups of eight to 12 psychiatrists, psychologists, and social workers in the four countries rated the extent to which each child displayed 18 hyperactive or disruptive behaviors. These include constant fidgeting or squirming, difficulty maintaining attention and finishing projects, a volatile temper, and becoming frustrated easily. …