Negotiating ADHD: Pragmatic medicalization and creolization in urban India

M. Nienke Slagboom*, Christian Bröer, Jonathan Berg

*Corresponding author for this work

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1 Citation (Scopus)
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Abstract

Although a growing number of studies have demonstrated differences in responses to ADHD-like behaviours, very few studies have focused on theorizing diversity in the way ADHD is framed and approached globally. To contribute to the study of medicalization in a global context, this study examines the discursive field in which care professionals explain and treat ADHD among children in metropolitan India and addresses the need for an analytic framework to grasp the variations in the way ADHD is understood and approached. Building on the concepts of pragmatic medicalization and creolization, we study ADHD discourses in India asking ‘What is at stake’ and ‘What matters most’?

In this mixed methods study, 64 care professionals regularly involved in assessing ADHD-like behaviour completed an online Q-sort, and 21 professionals participated in face-to-face interviews. The Q-data were subjected to factor analysis. The interviews were analyzed using qualitative content analyses.

Our study identified six distinct ADHD discourses, which showed that care professionals combine explanatory and treatment models. Professionals adapt their explanations and treatments of ADHD to parents’ worries regarding academic performance, family prestige, stigma and side effects of allopathic medicine. Our findings indicate that an awareness of local concerns and adjustments to structural opportunities can diversify how ADHD-like behaviour is framed and responded to.

This study demonstrates that medicalization operates between the emerging institutions of care and the everyday concerns of families and care professionals and reveals the need to examine conflicting stakes as drivers of diverse responses to ADHD diagnosis and treatment in India and the rest of the world.
Original languageEnglish
Article number114400
JournalSocial Science and Medicine
Volume289
DOIs
Publication statusPublished - Nov 2021

Bibliographical note

Funding Information:
This study would not have been possible without a range of people, to whom we wish to express our utmost gratitude. First and foremost, we thank the participants, who made time in their busy scedules and agreed to share their experiences. Further, Bharati Vidyapeeth Pune, KEM Hospital Pune, Sahyadri CGC Pune and New Horizons in Mumbai were supportive of our study. Dr. Leena Srivastava, Dr. Radhika Bapat and Bindu Patni and collegues: thank you for your invaluable help in organizing the study. Finally, we thank the two anonymous reviewers for their constructive feedback, which immensely improved our paper.

Publisher Copyright:
© 2021 The Authors

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