Discourses of risk, blame and legitimation: the social construction of attention deficit/hyperactiity disorder (ADHD)

Attention Deficit/Hyperactivity Disorder (ADHD), characterized by inattention and hyperactivity/impulsivity (APA, 2000), is currently the most common and debated childhood psychiatric diagnosis. ADHD has mobilized great social attention in the last decade and has primed a profound scientific and public controversy during the last years. Considering the circulation of competing perspectives, this research aims to analyze the discursive construction of ADHD by the key adults who interact with the child. The study involves relevant social actors who are engaged in the diagnostic/treatment processes of ADHD - mental health professionals, primary school teachers, and parents - that also belong to powerful social institutions for children’s education and socialization: the medical field, school and family. The theoretical framework integrates discourse analysis (Foucault, 1969; Parker, 2005) and positioning theory (Harré & Van Lagenhove, 1999). The general aim concerning the discursive construction of ADHD was articulated in two sub-aims. The first was to map the participants’ positioning repertoire, in terms of reflexive positioning, used to position oneself, and interactive positioning, used to position others. The second subaim was to analyze the discursive dynamics characterizing the interactions among the members of a self-help group of parents. The analysis allowed identifying three relevant discursive patterns. First, the discourse of risk, which transversally crosses the narratives of the participants and is related to the positioning of the child diagnosed with ADHD as both “at-risk” for himself and “risky” for others. Second, the blame embedded in the mutual positioning of the key adults surrounding ADHD children. The mutual blame is not merely related to the debate regarding the validity of the ADHD diagnosis. Rather, it is centered on questions of compliance, recognition of authority, and morality. Third, the self-legitimation towards which the narrative produced by the self-help group of parents is oriented. The shared narrative that parents construct functions as a ratified and consensual body of knowledge that constitutes a language to narrate what ADHD and a resource to counter blame and find legitimization for parents’ experiences. Overall, the results shows that ADHD is simultaneously a socially constructed and a “constructive“ object, as participants are involved in the process of constructing the child and his/her problem, but they are also negotiating their own and others’ subjectivity in relation to the “problematic” child.