The continued uneasiness around ADHD is perhaps owed to the fact that there is little scientific consensus about the disorder, argues scholar Susan Hawthorne. “Despite decades refining its diagnostic category,” she writes, “aspects of [medical, scientific, and social] understanding and practice remain unsettled or controversial.” To this day, scientists debate whether the disorder is a form of biological dysfunction or simply a medicalization of normal deviance, promoted by pharmaceutical companies to sell drugs to bigger and bigger populations.
https://daily.jstor.org/adhd-the-history-of-a-diagnosis/
A Disease Called Childhood: Why ADHD Became an American Epidemic
Marilyn WedgeA surprising new look at the rise of ADHD in America, arguing for a better paradigm for diagnosing and treating our children
In 1987, only 3 percent of American children were diagnosed with attention-deficit/hyperactivity disorder, also known as ADHD. By 2000, that number jumped to 7 percent, and in 2014 the number rose to an alarming 11 percent. To combat the disorder, two thirds of these children, some as young as three years old, are prescribed powerful stimulant drugs like Ritalin and Adderall to help them cope with symptoms. Meanwhile, ADHD rates have remained relatively low in other countries such as France, Finland, and the United Kingdom, and Japan, where the number of children diagnosed with and medicated for ADHD is a measly 1 percent or less.Alarmed by this trend, family therapist Marilyn Wedge set out to understand how ADHD became an American epidemic. If ADHD were a true biological disorder of the brain, why was the rate of diagnosis so much higher in America than it was abroad?
Language: English
Published by Oxford University Press, 2013
Science adds to our understanding of ADHD by working out mechanisms of causation, symptom production, and intervention. So far, despite alternative hypotheses, the sciences have also stood by models that align with DSM-defined ADHD. Why? In part because—allowing for significant gaps in scientific knowledge—the data fit, by and large. But science’s commitment to certain reasoning patterns and methodologies also encourages adherence. For example, sticking with the same model makes it simpler to demonstrate data convergence across fields: researchers can be more certain that they are comparing apples to apples. Similarly, the common focus on _difference_ (typically difference of “ADHD” from “non-ADHD”) meshes well with the DSM’s categorical portrayal of ADHD. These under-recognized effects of methodology, among other factors, slow down exploration of alternatives. Common methodologies and scientific goals also encourage dichotomization, reductionistic biological perspectives, and reification of ADHD—three aspects of the predominant view that contribute to intolerance.
More ambitiously, there are high-profile proposals to adopt a positive definition, identifying mental health with psychic or even overall well-being. We argue against both: a definition of mental health as mere absence of mental illness is too thin, too undemanding, and too closely linked to psychiatric value judgments, while the definition in terms of well-being is too demanding and potentially oppressive. As a compromise, we sketch out a middle position. On this view, mental health is a primary good, that is, the psychological preconditions of pursuing any conception of the good life, including well-being, without being identical to well-being.
psychoanalysis and all its attendant categories of trauma, repression, sublimation, and so on were getting purged from DSM-III,5 Boorse chose to ground his account of mental health, ostensibly scientific and objective, in the theory that was quickly losing ground in the psychiatric consensus.....Is health more than the “silence of the organs?”7 Boorse himself rejected the calls for a positive definition—they were prominent already in the 1970s—as entirely confused (Boorse, 1977, 568–70). The relevant medical concept is the negative one and the positive concept is mostly a rhetorical tool for enthusiasts of fitness, dieting, and other healthy living movements. Sure, prevention of disease is important, and these activities might be effective for that purpose, but nothing more than the standard negative definition is needed for that. Ideas that go under the label of positive health are only tools for reducing disease.
Diagnosis or Social Construct? - a 2025 ADHD Ph.D. thesis
