Categorically Complex: How do we conceptualize and understand the psychiatric classification ADHD?

Abstract

Psychiatric classifications are names that we give to clusters of symptoms. They were developed to standardize mental health care, but their impact has come to stretch well beyond that. Classifications shape the way we understand psychological differences between people, both in mental health practice and in society as a whole. In this thesis, we focus on the classification ADHD. First, we investigate how ADHD is understood by ADHD stakeholders and in psychoeducational materials. Then we explore how psychiatric classifications affect how a young adult is perceived by the public. Finally, we look at the clinical utility of reward sensitivity for predicting treatment outcome in ADHD. We show that our understanding of ADHD is characterized by conflict and ambivalence. This is evident not so much between different parties, but within individuals and within the overarching professional perspective on ADHD. These conflicts are caused by subtle but relevant misunderstandings in how we discuss and communicate about ADHD. We therefore highlight the importance of clear communication about what we do and do not know about psychiatric classifications and what they do and do not mean. Specifically, understanding of the nature of psychiatric classifications should extend beyond the research community. It should be shared, discussed and, most importantly, be interpreted with all stakeholders involved. If we work towards clear communication, we can ensure less misunderstanding and conflict, more focus on the individual needs, and we can improve how individuals with classifications understand themselves in the context of their difficulties.