Perspectives on ADHD in children and adolescents as a social construct amidst rising prevalence of diagnosis and medication use

• Published in: Frontiers in psychiatry Vol. 14; p. 1289157
• Main Authors: Banaschewski, Tobias, Häge, Alexander, Hohmann, Sarah, Mechler, Konstantin
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 2023
• Subjects: ADHD; attention-deficit/hyperactivity disorder; overdiagnosis; prevalence; stigma; treatment; ADHD; prevalence; treatment; stigma; attention-deficit/hyperactivity disorder; overdiagnosis
• ISSN: 1664-0640; 1664-0640
• DOI: 10.3389/fpsyt.2023.1289157

The diagnosis of attention-deficit hyperactivity disorder (ADHD) is based on the presence of pervasive, persistent symptoms of inattention and/or hyperactivity/impulsivity typically emerging early in life and resulting in significant functional impairment. In contrast to a worldwide epidemiological prevalence of approximately 5% in children and 2–3% in adults, there are significant variations in the prevalence of administrative ADHD diagnoses and medication use. We assert that in order to explore the underlying dynamics of this phenomenon, a thorough understanding of the construct ADHD is necessary. We contend that ADHD is not a natural entity that unfolds within an individual and can be understood independent from societal and environmental factors, but rather that ADHD as a diagnosis can better be conceptualized as a valid and pragmatically useful social construct. Decisions to diagnose and treat ADHD should follow a person-centered approach and be focused on functional impairment within a socially constructed, context-dependent and environmentally contingent model.