Reflections on ADHD in a Global Context

This chapter is a reflection on some of the findings presented and issues raised in the depictions of ADHD in the 16 countries presented in this book. As noted in the introduction, this volume is not meant to be a comprehensive depiction or comparative study per se, but rather a series of chapters presenting the state of ADHD in a global context. The goal of this final chapter is to highlight some patterns and idiosyncratic situations in the chapters, but we stop short of drawing conclusions. In working on this book, we have been struck powerfully by the paucity of a research-­ based understanding of the social dimensions , contributors, and ­ drivers of ADHD in a global context. Our pres­ ent phase of knowledge production requires more questions and more investigations, ahead of conclusions. Indeed, we hope that the many unresolved problematics arising across the chapters in this volume ­ will inspire further international social science studies of ADHD. Critics and advocates alike recognize that in the past three de­ cades ­ there has been a widespread medicalization of ­ children’s be­ hav­ ior, learning, and attention prob­ lems. By medicalization, we mean the pro­ cess by which nonmedical prob­ lems become defined and treated as medical prob­lems that often require medical treatment (Conrad 1992, 2007). Medicalization describes a so­ cio­ log­ i­ cal pro­ cess (like industrialization and secularization). This pro­ cess is not necessarily a prob­ 18 Reflections on ADHD in a Global Context Peter Conrad Ilina Singh Reflections on ADHD in a Global Context   377 lem, although critics have often used the term that way. ADHD is a classic case of medicalization (Conrad 1975) that has its roots in the United States, although the diagnosis and treatment of ADHD are becoming increasingly common in Eu­ rope, South Amer­ i­ ca, and Asia. The chapter on the United States gives a brief history of the medicalization of ADHD and the growing prevalence of the condition among both ­ children and adults in that country. Some might argue with the specific chronology, but, like many psychiatric disorders, the diagnosis we know as “ADHD” developed iteratively, in response to a changing constellation of be­ hav­ iors, alongside shifting etiological models, and in direct partnership with psychopharmaceutical treatments (Singh 2002). More recently, researchers have suggested that the spread of the ADHD diagnosis reflects the globalization (Conrad and Bergey 2014; Hinshaw and Scheffler 2014) of a medicalized category. The 16 chapters in this volume provide evidence of the continued medicalization of certain be­ hav­ iors of ­ children (and increasingly of adults) in a range of countries . This suggests that globalization may be an impor­ tant lens for understanding the spread and migration of the diagnosis.