The (Un)real Existence of ADHD — Criteria, Functions, and Forms of the Diagnostic Entity

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 via 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.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 via 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.Peer reviewe

The premise, promise and disillusion of the ADHD categorisation - family narrative about the child's broken school trajectory

This study presents co-narrated school experiences of a young Finnish girl diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and those of her parents. The discourse analysis of the family interview focused on the discrepant ways family members gave meanings to and mobilised the ADHD categorisation while narrating their broken school trajectory. The results showed that the ADHD diagnosis was laden with the promise of the whole family being recognised differently by the school. However, this cultural promise proved disillusioning as daughter's support needs and parents' expertise were not recognised nor did the diagnostic category emancipate from stigmatising identities and blame. Interestingly, the parents leaned more on the diagnostic categorisation while accounting for the disillusion of these promises, whereas the daughter aimed at distancing herself from the ADHD category and behaviour characteristics related to it. The discussion concludes by comparing the viewpoints of cure and care when catering to children's needs.Peer reviewe

ADHD in the DSM-5-TR: What has changed and what has not

In this opinion paper, we critically review the changes made to the DSM-5 Text Revision published in 2022 regarding the diagnostic entity of Attention Deficit / Hyperactivity Disorder (ADHD). We structure our critique around three points. The first discusses the acknowledgement of ADHD as a neurodevelopmental disorder. The second examines the definition of ADHD provided in the updated edition of the manual. The third scrutinizes the changes in the diagnostic criteria for ADHD and assesses whether these changes make the diagnosis more accurate. We point out how DSM-5-TR keeps the faith in the neo-Kraepelinian paradigm by explicitly and implicitly cultivating the essentialist medical scientific metaphor of disorder.In this article, we critically review the changes made to the DSM-5 Text Revision published in 2022 regarding the diagnostic entity of Attention Deficit/Hyperactivity Disorder (ADHD). We structure our critique around three points. The first discusses the acknowledgment of ADHD as a neurodevelopmental disorder. The second examines the definition of ADHD provided in the updated edition of the manual. The third scrutinizes the changes in the diagnostic criteria for ADHD and assesses whether these changes make the diagnosis more accurate. We conclude that DSM's latest edition does not escape the logical and scientific pitfalls of its predecessor. DSM-5-TR keeps the faith in the neo-Kraepelinian paradigm by explicitly and implicitly cultivating the essentialist medical scientific metaphor of disorder, creating the illusion that it represents scientific progress that validates ADHD as a neurodevelopmental disorder.Peer reviewe

Toiseuttava erityistarve – ADHD-diagnosoitujen nuorten identiteettineuvottelut heidän koulukokemuksissaan

Tämän diskurssianalyyttisen tutkimusartikkelin tarkoituksena on tuottaa perusteltu puheenvuoro toiseuttavia identiteettikategorioita tuottavan tarvediskurssin tarkasteluun peruskoulukontekstissa. Artikkelissa analysoidaan 13:n aktiivisuuden ja tarkkaavuuden häiriö -diagnoosin (ADHD) kanssa elävän nuoren identiteettineuvotteluita heidän koulukokemuksiaan koskevassa haastatteluvuorovaikutuksessa. Nuoret tuottivat erityisopetuksesta ja ADHD-diagnoosista haastatteluvuorovaikutuksessa lähtökohtaisesti itseään negatiivisesti määrittäviä sosiaalisia kategorioita pyrkimällä spontaanisti normalisoimaan identiteettinsä suhteessa niihin. Erityisoppilaasta ja ADHD-oppilaasta tuotettiin nuorten sisäistämiä toiseuttavia identiteettikategorioita. Artikkelissa pohditaan koulun roolia toiseuttavien diskurssien ylläpitäjänä ja purkajana problematisoimalla erityisen (tuen) tarpeen käsite, retoriikka ja käytännöt. Asiasanat: aktiivisuuden ja tarkkaavuuden häiriö (ADHD), toiseus, erityistarve, diskurssianalyysiPeer reviewe

Inclusive and Special Education and the Question of Equity in Education : The Case of Finland

Peer reviewe

Kasvatuksen ja koulutuksen kontekstien vammaistutkimuksellinen tarkastelu

Non peer reviewe

Autenttisuutta lääkitsemässä vai lääkitsemällä? ADHD-lääkitykselle annetut merkitykset nuorten identiteettien muokkaajana

Aktiivisuuden ja tarkkaavuuden häiriöksi luonnehditun ADHD:n lääkkeelliseen hoitoon liittyviä eettisiä kysymyksiä on pohdittu nuorten informoidun suostumuksen, toimijuuden ja identiteettityön näkökulmista. Tässä tutkimuksessa tarkastelimme, millaisia identiteettejä ADHD-lääkitystä käyttävät tai käyttäneet nuoret ja heidän vanhempansa rakentavat nuorille ja millaisia merkityksiä ADHD-lääkitys saa nuorten identiteettien muokkaajana. Tutkimusaineisto koostui nuorten (n = 11) ja heidän vanhempiensa (n = 17) puolistrukturoiduista haastatteluista, jotka analysoitiin diskurssianalyyttisesti. Tutkimustulokset osoittivat lääkkeiden käytön toimivan yhtäältä keinona irtautua nuoren poikkeavasta ADHD-identiteetistään ja saavuttaa ympäristön kannalta toivottava identiteetti, kun taas toisaalta lääkityksen käyttöön liitettiin omasta todelliseksi koetusta identiteetistä vieraantuminen. Tutkimustuloksia pohditaan sekä autenttisuuden käsitteen että lääkityspäätöksen autonomisuuden näkökulmista.Peer reviewe

Enhancing criticality and resistance through teaching in the neoliberal academy

Academic work and teaching in academia are undergoing major changes in the present neoliberal era. Our purpose in this article is to explore theoretically and in practice how to bring criticality and resistance to life through teaching in the academy and to demonstrate it is not necessarily always a narrative of success. The article is based on our experiences as critical scholars struggling to find ways to contribute to questions of education and social justice, both individually and jointly, over the past 20 years. In this article, we particularly want to examine some of the possibilities and challenges of bringing homo politicus back into the agenda of education

The Cultivation of Subjectivity of Young People in Youth Support Systems

In recent years Finland has witnessed a substantial amount of public debate and concern about vulnerability, well-being, mental-health problems, and anxiety among young people from various backgrounds. In accordance with the ethos of vulnerability and neoliberalism, people are supposed to become employable, resilient, and entrepreneurial, choosing education based on their expected individual needs and what they wish eventually to achieve in life. The focus in this article is on the ethos of vulnerability, and particularly on the cultivation of a vulnerable subjectivity through therapeutically and psychologically oriented knowledge in the neoliberal politics. It is based on individually and jointly produced data from various youth support systems in Finland, and on discussions with young people considered to be vulnerable or ‘at risk’ who are involved in these systems. We argue that both the therapeutic culture and neoliberal politics legitimise and accelerate cultivation of vulnerability while dismissing social expectations and pressure targeted on young people. Vulnerable subjectivity is strengthened by various types of specialists who claim that the self can achieve a better and more satisfying life through the application of psychologically and therapeutically engineered knowledge and professional skills.Peer reviewe