Honkasilta Juho, Koutsoklenis Athanasios
Department of Education, Faculty of Educational Sciences, University of Helsinki, Helsinki, Finland.
Department of Primary Education, Democritus University of Thrace, Alexandroupolis, Greece.
Front Sociol. 2022 May 30;7:814763. doi: 10.3389/fsoc.2022.814763. eCollection 2022.
The contemporary conceptualization of Attention Deficit Hyperactivity Disorder (ADHD) as a complex, multifactorial neurodevelopmental disorder cannot be understood as such without a complex assemblage of political, economic, and cultural processes that deem the conceptualization to be valuable and useful. In this article we use the notion of psychiatrization as a lens through which to see parts of these processes that make up ADHD what it is. In the first part of the article, we critically assess the scientific basis of the ADHD diagnosis examining its diagnostic criteria as presented in the current fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM), the so called "Bible" of modern psychiatry. The second part of the article asks what is done with the ADHD diagnostic entity and with the idea that it represents a natural neurodevelopmental state within an individual-something an individual has-as represented in the DSM-5. Drawn from our previous research, we analyze how ADHD becomes real in discourse practice as a powerful semiotic mediator through analysis of the various functions and forms in which it takes shape in institutional, social, and individual levels. We conclude that the frequent changes in the diagnostic criteria of ADHD do not reflect any real scientific progress. Among other reasons, they change to match better the maneuvers of individuals when navigating an increasingly psychiatrized society in the search for recognition, support, category membership, immunity, sympathy, and sense of belonging.
注意力缺陷多动障碍(ADHD)作为一种复杂的、多因素的神经发育障碍,其当代概念如果没有一系列政治、经济和文化过程的复杂组合,就无法被如此理解,这些过程认为该概念是有价值和有用的。在本文中,我们将精神医学化的概念作为一个透镜,通过它来审视构成ADHD现状的这些过程的部分内容。在文章的第一部分,我们批判性地评估了ADHD诊断的科学基础,审视了其在当前第五版《精神疾病诊断与统计手册》(DSM)中呈现的诊断标准,即现代精神病学的所谓“圣经”。文章的第二部分探讨了ADHD诊断实体以及它代表个体内一种自然神经发育状态(即个体所具有的某种东西)这一观念在DSM - 5中的呈现所带来的影响。基于我们之前的研究,我们通过分析ADHD在制度、社会和个体层面形成的各种功能和形式,来分析它如何在话语实践中作为一种强大的符号中介而变得真实。我们得出结论,ADHD诊断标准的频繁变化并未反映任何真正的科学进步。除其他原因外,这些变化是为了更好地契合个体在一个日益精神医学化的社会中寻求认可、支持、类别归属、豁免、同情和归属感时的策略。