by JR Ramsay and R Waite

Attention deficit hyperactivity disorder (ADHD) is a common lifespan neurodevelopmental disorder among school aged children. Moreover, it affects about 4.4 % of adults in US; only 11 % of them received specialized treatment. It is interesting to note that ADHD has a tendency to run in families, i.e., 40-60 % of parents with ADHD had an ADHD child. Despite the fact that parental ADHD is a definite barrier to the effective treatment of childhood ADHD, little of the clinical or research literatures deal with this issue, especially among minority and different ethnic groups.

The author’s review the role cultural context plays in the ways parents may understand the effects of ADHD and how they view treatment options for themselves (if they have ADHD) and their children with ADHD. Ethnic and cultural issues shape the parental perception and beliefs about the disorder. This notion is in accordance with a empirical research that reports the lax parenting styles of ADHD parents, in particular mothers (often the primary caretakers), who have children with ADHD. Consequently, in order to increase the likelihood of success, ADHD treatment interventions should be tailored to address the views of families including diverse cultural and ethnic groups

For example, the most widely used treatment for ADHD is a pharmacotherapy.  Within some cultural groups the perceptions about the side effects of medications as well as general skepticism about psychiatric medications may make families reluctant to pursue medication treatment, for either adult or child ADHD. Families with these doubts about medications may seek other forms of treatment, such as behavioral therapy or family counseling, or might pursue other community resources. Thus, the time spent establishing a good partnership with adult ADHD patients with regards to their outlooks on various treatment options is a good investment. Moreover, the authors suggest that licensed community primary healthcare providers may be the first professionals families seek for assistance. Hence, well designed training programs for this professional cohort may help them to perform brief screenings for adult ADHD and to deliver evidence-based treatments that are culturally sensitive.  The authors note that cross cultural issues related to ADHD and researching ADHD in underserved populations is an important area for future research.

Waite R, Ramsay JR. Adults with ADHD: Who are we missing? Issues Mental Health Nursing. 2010;31:670-8.