Psychiatrization Of Difference (ADHD)
In contrast many people dispute the medicalisation of ADHD, believing it offers a ‘quick fix’ to the issue regarding lack of expertise and knowledge to deal with the severity of challenging behaviours (Isaacs, 2006). Castel et al (1997) states that. ‘Psychiatrization of Difference’ is the way medicalisation legitamises deviancy as attributing unacceptable behaviour to medical terms normalises difference. Likewise Malacrida (2004:69) claims that teachers often feel frustrated about the lack of ‘social control’ which compels them into giving children with ADHD preferential treatment which is unwarranted; evidenced by low numbers of expulsions for those with ADHD. With this in mind, it is possible to suggest that educators are disempowered
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and perturbed from administering punishments to children with ADHD through fear it is classed as discriminatory. However, it can be argued that leniency not only condones disruptive behaviour, but actually perpetuates difference. The stigmatic label of ADHD can generate negative opinions which develops into a self-fulfilling prophecy where children with ADHD live up to the worst expectations (Eisenberg and Schneider, 2007).
For those with ADHD, future life-chances are potentially adversely affected on account of prejudice surrounding the label. This fact alone can be enough to persuade people into opposing the diagnosis of ADHD. Teachers may be one such group as, despite normally being the first person to observe and instigate an ADHD assessment (Sayal et al, 2006) their ongoing assistance does not always happen. Harborne et al (2004) discusses how numerous parents fail to gain teachers’ support to ensure the needs of a child with ADHD is properly addressed. These various conflicting views demonstrate a lack of collaborative work on behalf of the child’s best interests, yet partnership work is essential as interventions which have a holistic approach are more likely to secure positive outcomes for children with ADHD (Matte et al, 2007). Furthermore, promoting collaborative learning with a peer of the opposite sex can even enhance boys’ with ADHD educational performance, possibly because of a feminine calming effect (Watkins and Wentzel, 2008). Whilst Beckle (2004) reports that 93% of teachers believe that children with ADHD have a pre-disposed vulnerability, insufficient understanding of ADHD may explain their reluctance to engage accordingly.
There can be various reasons for resistance towards ADHD, one instance may occur due to questionability over the validity and reliability of diagnostic criteria. For example, ADHD can raise concerns about misdiagnosis as the symptoms often correspond to those of other illnesses. Therefore, differentiating between ADHD and other conditions, such as Autism, can be confusing and difficult; especially since both conditions present in behavioural issues which primarily affect boys (Jick et al, 2004). Whilst cultural diversity and children’s individuality makes each act differently from stipulated behaviours of ADHD (Critten, 2007). On the other hand, there could be an agreement with the debate claiming that society has developed into a ‘culture of disability’ (Stead et al, 2006:3). Described as an ‘engine of medicalization’, technology has been influential in raising awareness of ADHD (Maturo, 2012). Either via the internet or television, people have the means to gather information to make self-assessments. Whilst this information is preventative and beneficial for ensuring early support, prior knowledge can also be exploited as sources state that ADHD is potentially over-diagnosed. Not only is ADHD a condition where the symptoms are easily replicable, but the diagnosis process relies on self-reported symptoms. Furthermore, it is well documented that a ADHD diagnosis provides access to significant privileges, including extra time during exams and financial assistance. These factors could entice exaggerated cases, either falsifying subconsciously or on purpose. Thus, the prospect of some form of secondary gain may encourage malingering as, according to Harrison et al (2007), malingering influences 25% of people during tests. Nevertheless, the inability to determine motivation makes it almost impossible to separate genuine cases of ADHD from those that are falsified (Harp et al, 2001).
Parents are quite often the driving force pushing for an ADHD diagnosis, either for their own gratification or out of real concern for their child (Malacrida, 2004).
Yet, parents may actually contribute to the difficulties which children have. Assuming they know the best course of action, parents may take control and make decisions on the child’s behalf without consulting with them beforehand; denying the child the right of choice (Davis, 2006). Children may also be confined indoors due to parents fearing that the locality is unsafe. Not only does this mean children are unable to relinquish excess energy, but it is likely that children have been overstimulated with a combination of excessive amounts of television and consumption of vast quantities of additives (Armstrong, 2006). In retrospect, therapy highly recommends outdoor play as integration with peers minimises negative behaviours and promotes development of all children experiencing ADHD (Taylor and Kuo, 2011). These events tally with the opposing theory which claims that ADHD is socially constructed. Under this concept, the ‘childhood disorder’ label is contested as the ‘indicators’ of ADHD reflect the abundance of energy all children typically possess (Stead, 2006). Likewise, there is no evidence to confirm the credibility of ADHD medication as the drugs have the same calming effect on all children (Isaacs, 2006). The main focus in this contrasting view sees ADHD as a maladaptive response to environmental factors and events within the cultural context, including exposure to hostility and inconsistent parenting (Ladnierand and Massanari, 2000). The understanding behind Attachment Theory helps explain some behaviours which present with ADHD as according to Crittenden (2007) ADHD often co-exists with insecure attachment
styles.
Nevertheless, irrespective of which point is taken regarding the onset of ADHD it is ultimately pharmaceutical companies which reap the greatest rewards from the condition. Termed as a ‘cash cow’, ADHD has generated the pharmaceutical industry profits of almost $40 million over a 5-year period (O’Meara, 2013). Drug companies have vastly increased investment within advertising, whilst celebrities known for ‘suffering’ with the same ‘illness’ are recruited into campaigns to raise ‘awareness’ of ADHD (Kage, 2006). According to Gerald (2010) incorporating celebrity usage is a technique to gain the consumer’s trust and demonstrate credibility to the company’s motives. Yet what businesses are actually ‘disease mongering’ and inventing ‘illnesses’ which shape understanding and misleads the public into thinking they are unwell and need drugs to combat the effects. By plying on people’s insecurities, companies are able to exploit vulnerability for financial gain (Moynihan et al, 2002). At the same time, company belief that research is cost-ineffective results in less monies ploughed into that area (Maturo, 2011). Inevitably it is children that fair worse as, although their well-being is supposed to be safeguarded, it can be suggested that medication prescribed for ADHD puts children’s health at risk. According to Nissen (2006) Ritalin, commonly prescribed for ADHD, is strongly associated with heart failure as it is in the same category as the street-drug ‘speed’ which raises the heart rate. Furthermore, the long-term effects of stimulant medication remain unknown (CDC, 2005).
and perturbed from administering punishments to children with ADHD through fear it is classed as discriminatory. However, it can be argued that leniency not only condones disruptive behaviour, but actually perpetuates difference. The stigmatic label of ADHD can generate negative opinions which develops into a self-fulfilling prophecy where children with ADHD live up to the worst expectations (Eisenberg and Schneider, 2007).
For those with ADHD, future life-chances are potentially adversely affected on account of prejudice surrounding the label. This fact alone can be enough to persuade people into opposing the diagnosis of ADHD. Teachers may be one such group as, despite normally being the first person to observe and instigate an ADHD assessment (Sayal et al, 2006) their ongoing assistance does not always happen. Harborne et al (2004) discusses how numerous parents fail to gain teachers’ support to ensure the needs of a child with ADHD is properly addressed. These various conflicting views demonstrate a lack of collaborative work on behalf of the child’s best interests, yet partnership work is essential as interventions which have a holistic approach are more likely to secure positive outcomes for children with ADHD (Matte et al, 2007). Furthermore, promoting collaborative learning with a peer of the opposite sex can even enhance boys’ with ADHD educational performance, possibly because of a feminine calming effect (Watkins and Wentzel, 2008). Whilst Beckle (2004) reports that 93% of teachers believe that children with ADHD have a pre-disposed vulnerability, insufficient understanding of ADHD may explain their reluctance to engage accordingly.
There can be various reasons for resistance towards ADHD, one instance may occur due to questionability over the validity and reliability of diagnostic criteria. For example, ADHD can raise concerns about misdiagnosis as the symptoms often correspond to those of other illnesses. Therefore, differentiating between ADHD and other conditions, such as Autism, can be confusing and difficult; especially since both conditions present in behavioural issues which primarily affect boys (Jick et al, 2004). Whilst cultural diversity and children’s individuality makes each act differently from stipulated behaviours of ADHD (Critten, 2007). On the other hand, there could be an agreement with the debate claiming that society has developed into a ‘culture of disability’ (Stead et al, 2006:3). Described as an ‘engine of medicalization’, technology has been influential in raising awareness of ADHD (Maturo, 2012). Either via the internet or television, people have the means to gather information to make self-assessments. Whilst this information is preventative and beneficial for ensuring early support, prior knowledge can also be exploited as sources state that ADHD is potentially over-diagnosed. Not only is ADHD a condition where the symptoms are easily replicable, but the diagnosis process relies on self-reported symptoms. Furthermore, it is well documented that a ADHD diagnosis provides access to significant privileges, including extra time during exams and financial assistance. These factors could entice exaggerated cases, either falsifying subconsciously or on purpose. Thus, the prospect of some form of secondary gain may encourage malingering as, according to Harrison et al (2007), malingering influences 25% of people during tests. Nevertheless, the inability to determine motivation makes it almost impossible to separate genuine cases of ADHD from those that are falsified (Harp et al, 2001).
Parents are quite often the driving force pushing for an ADHD diagnosis, either for their own gratification or out of real concern for their child (Malacrida, 2004).
Yet, parents may actually contribute to the difficulties which children have. Assuming they know the best course of action, parents may take control and make decisions on the child’s behalf without consulting with them beforehand; denying the child the right of choice (Davis, 2006). Children may also be confined indoors due to parents fearing that the locality is unsafe. Not only does this mean children are unable to relinquish excess energy, but it is likely that children have been overstimulated with a combination of excessive amounts of television and consumption of vast quantities of additives (Armstrong, 2006). In retrospect, therapy highly recommends outdoor play as integration with peers minimises negative behaviours and promotes development of all children experiencing ADHD (Taylor and Kuo, 2011). These events tally with the opposing theory which claims that ADHD is socially constructed. Under this concept, the ‘childhood disorder’ label is contested as the ‘indicators’ of ADHD reflect the abundance of energy all children typically possess (Stead, 2006). Likewise, there is no evidence to confirm the credibility of ADHD medication as the drugs have the same calming effect on all children (Isaacs, 2006). The main focus in this contrasting view sees ADHD as a maladaptive response to environmental factors and events within the cultural context, including exposure to hostility and inconsistent parenting (Ladnierand and Massanari, 2000). The understanding behind Attachment Theory helps explain some behaviours which present with ADHD as according to Crittenden (2007) ADHD often co-exists with insecure attachment
styles.
Nevertheless, irrespective of which point is taken regarding the onset of ADHD it is ultimately pharmaceutical companies which reap the greatest rewards from the condition. Termed as a ‘cash cow’, ADHD has generated the pharmaceutical industry profits of almost $40 million over a 5-year period (O’Meara, 2013). Drug companies have vastly increased investment within advertising, whilst celebrities known for ‘suffering’ with the same ‘illness’ are recruited into campaigns to raise ‘awareness’ of ADHD (Kage, 2006). According to Gerald (2010) incorporating celebrity usage is a technique to gain the consumer’s trust and demonstrate credibility to the company’s motives. Yet what businesses are actually ‘disease mongering’ and inventing ‘illnesses’ which shape understanding and misleads the public into thinking they are unwell and need drugs to combat the effects. By plying on people’s insecurities, companies are able to exploit vulnerability for financial gain (Moynihan et al, 2002). At the same time, company belief that research is cost-ineffective results in less monies ploughed into that area (Maturo, 2011). Inevitably it is children that fair worse as, although their well-being is supposed to be safeguarded, it can be suggested that medication prescribed for ADHD puts children’s health at risk. According to Nissen (2006) Ritalin, commonly prescribed for ADHD, is strongly associated with heart failure as it is in the same category as the street-drug ‘speed’ which raises the heart rate. Furthermore, the long-term effects of stimulant medication remain unknown (CDC, 2005).