The Risk Society and Attention Deficit Hyperactivity Disorder (ADHD): A Critical Social Research Analysis concerning the Development and Social Impact of the ADHD Diagnosis
Kean, Brian, Ethical Human Psychology and Psychiatry
This article reports the findings of a research study that used a critical social research methodology to review the increase in use of the diagnosis of attention deficit hyperactivity disorder (ADHD) and conceptualized the phenomenon within a theoretical framework based upon Beck's (1992, 1999) periodization of social change, the Risk Society. The study was qualitative in nature. Data were drawn from a wide range of sources including legitimating hearings, reports and studies, texts and seminal documents, field observation in schools and classrooms, an electronic discussion/bulletin board, and in-depth interviews with parents and teachers. The analysis used a critical framework to locate specific instances of claim and counter-claim and to set the historical context for understanding the "modern biological" method of intervention with children considered by parents and teachers as having ADHD. The findings of the study are structured in the context of risks. Further research will inform whether the risks become threats. Through exposure of silences, myths, contradictions and power relationships that create risks surrounding the ADHD phenomenon, it is hoped that discourse concerning the hegemonic medical model of ADHD in research and in the wider community will be further critically examined.
Keywords: attention deficit hyperactivity disorder; social research; hyperkinetic
Since the late 1960s in the United States, millions of parents have been told that their children suffer from a condition known as attention deficit hyperactivity disorder (ADHD) or one of the antecedent labels for the condition, attention deficit disorder (ADD) or the hyperkinetic reaction of childhood. The hyperkinetic reaction to childhood replaced the diagnosis of minimal brain dysfunction (MBD) that had been previously used to classify a broad range of behavior and learning disorders (Barkley, 1990, 1998; Schrag & Divoky, 1975). The distinction between the hyperkinetic reaction to childhood and the MBD category was the removal, in the diagnosis, of the need to establish specific evidence of neurological damage. The requirement of evidence of neurological damage to the child was replaced by a reliance upon observations of the child's behavior, generally reported to the medical practitioners by parents or teachers, as evidence of existence of the condition (Barkley, 1990, 1998).
For more than 30 years the diagnosis and treatment with amphetamine and other drugs for treatment of ADHD were phenomena almost unique to the United States and to a lesser degree, Canada (Diller, 1998). During the 20-year period from 1970 to 1990, the prevalence of the condition in the United States doubled around every 7 years (Divoky, 1989). In the rest of the world, hyperactivity was still seen as a rare condition resulting from an identifiable neurological disorder often associated with intellectual disability or other forms of neurological damage resulting from childhood diseases (Barkley, 1990, 1998).
In contrast to other scientific and medical advances, the recognition of the condition ADHD was only relatively recently adopted by any other countries. Before 1990, conflicting viewpoints in the medical profession resulted in dramatic differences between the level of use of drugs for treatment of ADHD in the United States and usage in the rest of the world (Barkley, 1990, 1998). It was not until the last years of the 1980s that the international medical viewpoint on the condition changed and other countries began to use the ADHD diagnosis (Barkley, 1990, 1998; Rutter, Tuma Ok Lann, 1988). In the 10-year period from 1990 to 2000 the diagnosis of ADHD had moved rapidly towards global acceptance.
The diagnosis of ADHD is based upon the child demonstrating a collection of behavioral symptoms that disrupt functioning in the classroom and their home (Bender, 1997). The diagnosis is psychiatric and is not based upon a clinical test for a biological disorder (Breggin, 2001; Divoky, 1989; Hughes & Brewin, 1979). …