A linguistic analysis of in-office dialogue among psychiatrists, parents, and child and adolescent patients with ADHD.
OBJECTIVE
The aim was to evaluate in-office discussions of ADHD and psychiatric comorbidities.


METHODS
Naturally occurring interactions among 11 psychiatrists, 32 patients and their parents were recorded, with a focus on "complicated" patients (i.e., having or suspected to have >or= 1 psychiatric comorbidities and/or learning disabilities in addition to ADHD). Participants were interviewed separately post visit. Transcripts were analyzed using validated sociolinguistic methodologies.


RESULTS
Some 62% of patients were male, with an average age of 12.5 years, and 79% had a family history of ADHD. Visits were psychiatrist-driven, focusing on medication management and school performance, leaving management of comorbidities largely unaddressed. Post visit, 78% of parents and psychiatrists disagreed on patients' "most concerning behavior." Parents most often reported concern about aggression and oppositionality. Psychiatrists and parents emphasized different aspects of patients' personality, using deficit- and strength-based models, respectively.


CONCLUSIONS
Psychiatrists and parents interpreted the relationship between ADHD and comorbidities differently. The significant incidence of misalignment regarding worrisome behaviors warrants further exploration.
Findling
Robert L
RL
Case Western Reserve University, USA.
Connor
Daniel F
DF
Wigal
Timothy
T
Eagan
Corey
C
Onofrey
Meaghan Nelson
MN