Dartmouth Medical School postdoctoral researcher Elizabeth Carpenter-Song finds diverse meanings and experiences of two mental disorders known as Attention Deficit Hyperactivity Disorder (ADHD) and Pediatric Bipolar Disorder (PBD) among families in the United States. The finding was published this month in Culture, Medicine and Psychiatry.
From a medical perspective, ADHD is a condition that affects children in early school years and is characterized by inattention, hyperactivity and impulsivity.
PBD is a mental condition characterized by severe fluctuations in mood, activity, thought and behavior. Both ADHD and PBD are being increasingly diagnosed and treated in youth in the U.S., where PBD in children was considered virtually nonexistent until recently.
“There has always been a deep curiosity within me to what is occurring when there is an increasing number of children diagnosed with mental disorders and to observe how these children and their families view their problem and what their day-to-day life is like. The goal for the research is to explore how health diagnoses like ADHD and PBD take shape within the family,” said Carpenter-Song.
Carpenter-Song conducted a 13-month ethnographic study of the lived experience of ADHD and PBD in 20 diverse families (n=20) living in the United States that self-identified as African-American (n=9), Euro-American (n=10) and Latino (n=1) backgrounds.
An ethnographic study is a method of observing human interactions in social settings. The families differed not only in ethnicity but also in socioeconomic circumstances, ranging from low- to upper-middle income.
Carpenter-Song found that overall, medicalized perspectives hold less salience to African-American families than to Euro-Americans in the study. Despite the dominance of biochemical and neurological explanations for mental problems in contemporary U.S. culture, the study revealed that nonpathological interpretations are far from having been wholly eclipsed.
Of the 20 families that were followed, specifically three are detailed in the paper to illustrate the differing perspectives on ADHD and/or PBD among families. The Martin family typifies the many Euro-American families in the study who viewed the mental conditions of their children through purely a medical lens. This is exemplified by the mother Cassie Martin’s perspective regarding her ADHD-diagnosed son who “was just born with a chemical imbalance.”
In contrast, the African-American Williams family, exemplifying many African-American families in the study, actively questioned mental health interventions and the grandfather Bill Williams remarked, “It’s a bunch of hogwash…You just have to control yourself…That’s not how society works.”
Meanwhile, the Euro-American Danner family was at first strongly ambivalent towards medical interventions and then drastically changed its stance. This type of reaction is characteristic of Euro-American families in the study who appeared to get caught up in a quest to find both a definitive explanation and solution for what Carpenter-Song considers to be the “cruelty of daily life.”
“People should see the range of experiences families go through when dealing with these mental problems and that all the families are constantly struggling and searching for meaning or relief. As seen through the Martin and Danner family, interpretations differ even within the same ethnicity. There really is no magic bullet in treating these problems. I strongly encourage the inclusion of family dynamics into the medical conversation and I hope that this research will have a positive impact on clinical practices in the future,” said Carpenter-Song.