A name, what's in a name? The medicalization of hyperactivity, revisited.
Although attention-deficit hyperactivity disorder has in recent years become one of the most common psychiatric problems diagnosed in children, its status as a medical disorder remains controversial, especially in Britain. This study examines the experience of parents and doctors dealing with hyperactive children, focusing in particular on the process of medicalization. It alms at understanding what is at stake for families and doctors and asks about the role of a medical label in the therapeutic process. It uses an anthropologically informed methodology, in which qualitative semistructured interviews of 1-2 hours duration were held with 29 parents of hyperactive children and 10 general practitioners. Interviews were audiotaped; the content was transcribed and analyzed according to grounded hermeneutic theory. It was found that raising a hyperactive child can provoke a profound sense of alienation in parents. Family and social roles are affected, as are parents' views of themselves in their parental and social roles. Parents tended to experience medicalization and labeling as important aspects of validation and legitimation of their experience, which gave them a sense of control and led to improved parent-child relationships. Doctors felt more reluctant about such medicalization, fearing that it could lead to scape-goating the child and to self-fulfilling prophecies. It may be concluded that the medical framework, especially the medical diagnosis, can provide a powerful tool that has both advantages and disadvantages in the therapeutic process. In trying to avoid stigmatization, doctors can delegitimate parents' experience, thus increasing their suffering.
Klasen
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South West London and St. George's Mental Health NHS Trust, England.
D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000523:psychology*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000523:psychology; D002648:Child; D015986:Confounding Factors, Epidemiologic; D003469:Culture; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D010287:Parent-Child Relations; D016487:Parenting; D010818:Practice Patterns, Physicians'; D012494:Sampling Studies; D012938:Social Perception; D006113:United Kingdom