Hidden in plain sight: how individual ADHD stakeholders have conflicting ideas about ADHD but do not address their own ambivalence.

Psychiatric classifications refer to clusters of behavioral symptoms. We know much about how psychiatric classifications are intended to be used in theory. Yet the scientific study of the practice of classification to date is limited. We aimed to explore how individuals navigate and make sense of the complexity surrounding an ADHD classification. We used thematic analysis to analyse stakeholder perspectives from seven focus groups: adults classified with ADHD, adolescents classified with ADHD, parents of children classified with ADHD, clinicians, researchers, teachers, and policy makers. We found seven themes in how stakeholders navigate the classification ADHD. Yet, what stood out was an overarching discursive pattern: individual stakeholders expressed highly ambivalent ideas about ADHD but did not address their own ambivalence. We suggest that promoting a social kinds perspective on ADHD may help us navigate the complexity and ambivalence associated with ADHD more competently.

Lost in explanation: internal conflicts in the discourse of ADHD psychoeducation.

BACKGROUND: Psychiatric classifications are understood in many different ways. For children with ADHD and their parents, psychoeducation is an important source of information for shaping their understanding. Moreover, psychoeducation is often taken by children and parents to represent how their story is understood by the therapist. As a result, the way psychoeducation is formulated may affect the therapeutic alliance, one of the most robust mediators of treatment outcome. In addition, psychoeducation may indirectly influence the way we understand psychological differences as a society. METHODS: To better understand how the classification ADHD is given meaning through psychoeducation, we analyzed 41 written psychoeducational materials from four different countries; the USA, UK, Netherlands and Hungary. RESULTS: We identified five patterns of how the materials construct the discourse on ADHD. Notably, tension between biomedical and psychosocial perspectives resulted in conflict within a single thematic stance on ADHD as opposed to a conflict between parties with a different vision on ADHD. There were only few differences between countries in the way they constructed the discourse in the materials. CONCLUSIONS: These conflicts cause confusion, misrepresentation and decontextualization of ADHD. Ultimately, for those diagnosed with ADHD and their parents, conflicting information in psychoeducation materials may hamper their ability to understand themselves in the context of their difficulties.

Which Child Will Benefit From a Behavioral Intervention for ADHD? A Pilot Study to Predict Intervention Efficacy From Individual Reward Sensitivity.

Objective: This article aims to assess whether individual differences in reward sensitivity can be used to predict which children with attention-deficit/hyperactivity disorder (ADHD) will benefit most from behavioral interventions that include reinforcement. Methods: A 12-week behavioral intervention was offered to 21 children with ADHD and their parents. Reward sensitivity was assessed prior to the intervention using a combination of psychological and physiological measures. ADHD symptoms were assessed pre- and posttreatment using the Strengths and Weaknesses of ADHD and Normal behavior (SWAN) rating scale. Results: Lower scores on one of the questionnaire scales were associated with greater pre/posttreatment differences in ADHD symptoms. Conclusion: We found that pre/posttreatment change was associated with one measure of parent-rated reward sensitivity. Children with low impulsive negative behavior toward gaining reward improved most during treatment. This result suggests that aspects of reward-related behaviors in ADHD may be useful to predict the effectiveness of treatment.