title: A linguistic analysis of in-office dialogue among psychiatrists, parents, and child and adolescent patients with ADHD.
abstract: 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.
authors.affiliation: Case Western Reserve University, USA.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Findling
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Connor
authors.forename: Timothy
authors.initials: T
authors.lastname: Wigal
authors.forename: Corey
authors.initials: C
authors.lastname: Eagan
authors.forename: Meaghan Nelson
authors.initials: MN
authors.lastname: Onofrey