Thu Le

A08370904
ANSC 121
A Disorder Humans Developed?
Three to seven percent of school age children in the United States are labeled
with ADHD. Between 2003 and 2007, the rate of ADHD diagnosis went up 5.5% each
year. The prescription of psycho stimulants such as Ritalin and Adderall
skyrocketed in conjunction with this increase. Why does this number continue to
rise? Why have not we fixed something as simple as focus issues yet? One of ADHDs
main debates is on the disorders origin. A cross-cultural study between ADHD in
the US and in France lets us see the two frameworks ADHD is represented in,
biological and psychosocial. Another debate questions the validity of the disorder
itself. ADHD has been hypothesized as a marketing scheme and/or as a social
construct that has been contrived to displace blame. A combination of medical and
social actions reinforces the credibility of ADHD.
ADHD or Attention Deficient Hyperactivity Disorder is commonly associated
with three symptoms: inattention, hyperactivity, and impulsivity. Poor performance
in school and behaviors like fidgeting and impatience are some observable
symptoms in kids. Ken Jacobson conducted a study of ADHD behavior in children in
the US and in Britain. His studies found that both countries equally displayed ADHD
behaviors but for some reason though, the United States has a significantly higher
number of clinically diagnosed children. This fact can be attributed to how each
country approaches the disorder.
In the United States, ADHD is viewed as something that is biological,
something located within the genome. The gene primarily linked with ADHD is the
1

DRD4 (dopamine receptor D4) specifically with the presence of the 7R allele. When
this allele is present, there was a higher exhibition of the ADHD behaviors. The 7R
allele is found across all types of populations but appearing most in migrating
populations (or those with history of migration). It is argued that this genetic
combination is an evolutionary consequence. This is the central idea of the Farmer
vs. Hunter theory proposed by Thom Hartmann. Hartmann hypothesized that the
origins of ADHD is a residual effect leftover from evolution. Humans were nomadic
hunters until the introduction of agriculture and pastoral living. Characteristics, like
hyperfocus, of ADHD were beneficial in the wild, where humans would need to be in
tune with many different factors during the hunt. After becoming sedentary,
however, the focus of humans was drawn in, but some still retrained ADHD
tendencies. With fewer things to direct attention to, the once beneficial adaptive
behavior of ADHD is now maladaptive in the present society environments, such as
the classroom. These unhelpful habits are regulated today by psycho stimulants
such as Ritalin.
In France, ADHD is viewed to stem from psychosocial causes, to be induced
from a patients context. Rather than treatment by drugs, French psychiatrists
prefer to figure out the origin of distress that would causes a childs erratic behavior
and try to regulate/adjust with therapy. Marilyn Wedge states that the difference in
child rearing practices may play into the lower numbers of ADHD kids in France.
French families have a different view of discipline from American families. They
bring up a child with a firm cadre or structure. French children are not as coddled as
much as American children are, they learn to live by the rules set by their parents,

not the rules set by their crying selves (Wedge, 2012). The social context of the
children played a determinant of the likelihood of that child developing ADHD.
The difference in treatments in the two countries can be seen through the
process of diagnosis. US psychiatrists use the Diagnostic and Statistical Manual
(DSM) as their official text, while French psychiatrists refer to the International
Classification of Disease (ICD) and French Classification of Children and Adolescent
Mental Disorders (CFTMEA). The orientations to the diseases are drastically
different between the texts (DSM vs. ICD & CFTMEA). DSM has a reductionist
diagnostic approach, focusing on a patients overt symptoms. Symptoms are viewed
as the manifestation of an underlying biological disorder, regardless of social
context (Vallee, p9). CFTMEA has a holistic psychopathological approach, which
accounts for the origins of the symptoms, how symptoms relate to one another, and
the structural organization of the disorder within which they are included (Vallee,
9). The DSM used to have a focus on psychoanalysis but with its third major
revision, it was taken over by biological psychiatrists. In general, CFTMEA and ICD
are more restrictive on their requirements of diagnosis compared to DSM. Between
1987 and 1994 the number of problematic ADHD behaviors that could be
recognized as symptoms in DSM increased. This broad definition of ADHD in the
DSM allowed for a higher diagnostic rate in the United States. One might think
though, why are we trying so hard to let more people be recognized with his
disorder?
When did lack of focus and hyperness become not a trait of children? Mental
illnesses do not arise in nature but are constituted by social systems of meaning

(Vallee, p5). The generation that we live in is the most stimulating era in human
history. We are accustomed to giving short bursts of attention that remaining
focused in one setting would seem to prove difficult. But is short attention span
really enough to warrant the classification and recognition of a disorder?
There are three main driving sources hypothesized for the conception of
ADHD: the pharmaceutical industry, the school system, and patients and parents
(Edwards et. l., p5). With a new medically recognized disorder, the pharmaceutical
industry has potential for a new market demographic and to make more profit.
Medication for the disorder validates the existence of the condition (Edwards et.
al., p9). If we have a drug to fix it, it must exist. The authority placed on the
medicinal field grants the industry to have weak opposition. With the recognition of
ADHD, teachers could categorize between different groups of children and act
accordingly to achieve their goals. In cases of ADHD, a teacher may ask parents to
get a student tested and see if there is medication to help the student. The existence
of ADHD allows parents to counter accusations of bad parenting by attributing
blame to a biological disorder. The diagnosis becomes cathartic, releasing any
possible guilt they may hold to themselves. Parents seek medical recognition as a
means of gaining validity and legitimacy: it enables them to state the fact of the
disorder (Edwards et. al., p10). Medicalisation, or defining behavior as a medical
problem or illness and mandating or licensing the medical profession to provide
some type of treatment for it" (Edwards et al, p10) allowed for parents to fight the
disease regime [] [where they are] demonized as bad parents(Edwards et. al.,
p13).

HyperSupers is a French support group created for families with children

diagnosed with ADHD. Parents are able to call in and ask questions or browse the
online site of testimonials from other families in their situation. The creation of this
space legitimizes and reinforces a parents idea that ADHD is a true disorder. The
organization has created a real space in which a real disorder can exist. Authorities
and the general public share this space and by creating this dialogue ADHD is alive
and real. In addition to helping families cope, the organization also aimed to spread
awareness of ADHD, to state the fact, and clear up misconceptions. They approach
the disorder not only from just one approach (i.e. neurological) but provide facts
from all science disciplines boosting their credibility. The interaction between this
space and society does performative work for the people affected by ADHD. The
disorder is allowed to be identifiable through this interaction.
In summary, ADHD is a multifaceted entity with ongoing disputed issues. The
United States classifies ADHD as something biological and controllable by the
psycho stimulants. The DRD4 7R allele may have been leftover from our hunting
past giving us hyperactive tendencies. France tackles ADHD with behavioral
therapy, as social and psychological causes are seen behind the disorder. The more
disciplined children of France may contribute to Frances low ADHD numbers. The
approaches to ADHD have been reinforced by diagnostic texts DSM, ICD, and
CFTMEA. The DSM used mainly in the US has a broader definition of ADHD and
focused on what symptoms a patient have. The ICD and CFTMEA focus on the
relationship of the symptoms within the disease and to its social context. ADHD then
again may not stem from biological or psychological factors but be completely

fantasized by society. The disorder may have been commodified by pharmacies to

gain hegemony and profit. Teachers and parents accept ADHD as legitimate in order
to draw blame away from themselves, to a biological factor they had no control over.
Medicalisation of the disorder gives teachers and parents the validation they are not
solely held responsible. Support groups like HyperSupers affirm the existence of
ADHD by a created space for discourse. Whether Attention Deficient Hyperactivity
Disorder is a cultural construct or a true viable disease, the excuse of ADHD
continues to grow year after year.

Works Cited
"ADHD - Interview with Ken Jacobson." ADHD - Interview with Ken Jacobson. Stay Free!, n.d. Web.
28 May 2013.
Baughman, Fred, Peter Breggin, Russell Barkley, William Dodson, Peter Jensen, and Harold
Koplewicz. "Does ADHD Exist?" PBS. PBS, n.d. Web. 29 May 2013.
"Data & Statistics." Centers for Disease Control and Prevention. Centers for Disease Control and
Prevention, 13 May 2013. Web. 29 May 2013.
Edwards, Claire, Etaoine Howlett, Madeleine Akrich, and Vololona Rabeharisoa. "Attention Deficit
Hyperactivity Disorder in France and Ireland: Parents Groups Scientific and Political
Framing of an Unsettled Condition." (2012): n. pag. Web. <http://www.csi.minesparistech.fr/>.
Eisenberg, Dan, and Benjamin Campbell. "The Evolution of ADHD Social Context Matters." San
Francisco Medicine (2011): n. pag. Web.
Jacobson, Ken. "ADHD in Cross-Cultural Persepctive: Some Empirical Results." American
Anthropologist (2002): n. pag. Print.
Mensen, Peter, David Mrazek, Penelope Knapp, Laurence Steinberg, Cynthia Pfeffer, John
Schowalter, and Theodore Shapiro. "Evolution and Revolution in Child Psychiatry: ADHD as
a Disorder of Adaptation." American Academy of Child and Adolescent Psychiatry 36.12
(1997): 1672-679. Web.
Pal, E. K. Education Psychology. N.p.: Pinnacle Technology, 2007. Google Books. 7 Jan. 2007. Web.
Vallee, Manuel. "ADHD: BIOLOGICAL DISEASE OR PSYCHOSOCIAL DISORDER? Accounting for the French-American Divergence in Ritalin Consumption." Diss. University
of California, Berkeley, n.d. Abstract. N.p., n.d. Web.
Wedge, Marilyn. "Why French Kids Don't Have ADHD." Psychology Today. N.p., 8 Mar. 2012. Web.
"What Is ADHD? Attention Deficit Hyperactivity Disorder: What You Need to Know." WebMD.
WebMD, n.d. Web. 29 May 2013.